HIFU联合金属胆道支架置入治疗胰腺癌的初步临床观察

目的探讨HIFU联合金属胆道支架置入治疗胰腺癌的安全性和有效性。 方法8例肝外胆道梗阻和疼痛患者支架减黄后HIFU治疗。治疗后1、3、7d分别行肝功、血糖、血尿淀粉酶、大便常规及隐血检查。HIFU后腹部X-片、CT或MRI随访。 结果HIFU后8例中7例疼痛减轻,其中6例疼痛控制满意。所有患者无黄疸加重和淀粉酶、大便异常。腹部X-片、CT随访,无支架变形、移位、闭塞。增强MRI随访,3例肿瘤完全坏死,2例坏死体积〉80%,2例坏死体积〉50%,1例坏死体积〈50%。 结论HIFU联合金属胆道支架置入治疗胰腺癌是安全、有效的,是肝外胆道梗阻胰腺癌可选择的一种局部治疗方法。

HIFU Plus Metallic Biliary Stent Insertion in Treatment

Objective To evaluate the safety and effects of high intensity focused ultrasound(HIFU)plus metallic biliary stent insertion in the treatment of pancreatic carcinoma.Methods Eight pancreatic carcinoma patients with extrahepatic biliary obstruction and pain underwent HIFU followed by insertion of a Ni-Ti expandable metallic stent.Liver function,serum glucose,serum amylase and urine,stool routine and occult blood(OB)were tested respectively on 1,3 and 7 d after HIFU.At 2 weeks after HIFU abdomenal X-ray and enhanced MRI or CT were performed.Results The pain of 7 in 8 patients were palliated greatly and pain in 6(6/7)was stopped.The chemical tests such as bilirubin,amylase and glucose were not obviously changed after HIFU.The OB were negative in all patients after HIFU.The location,shape and size in diameter of the stents were not changed obviously after HIFU.Enhanced MRI after HIFU showed that 3 patients had the tumor ablated completely,2 patients with > 80% of tumor volume ablated,2 patients with > 50% of tumor volume ablated and 1 patient with <50% of tumor volume ablated.Conclusions HIFU plus metallic stent may be a safe and effective modality for treating pancreatic carcinoma with biliary obstruction.It may become one of non-invasive effective treatment methods for these patients.