介入化疗栓塞在宫颈癌手术治疗中的应用

目的探讨应用子宫动脉灌注化疗及血管栓塞疗法对中晚期宫颈癌的手术治疗价值.方法对30例Ⅱb期～Ⅲb期的宫颈癌患者行介入化疗栓塞术,介入治疗后10～15 d行广泛性子宫切除及盆腔淋巴结清扫术.结果介入治疗后造影显示双侧子宫动脉闭塞,肿瘤染色消失.临床症状缓解总有效率为90%(27/30).手术中见肿瘤体积缩小,子宫表面苍白,宫旁粘连轻,易剥离,术中出血少;术后病理切片可见大片癌细胞凝固坏死,细胞核溶解、消失,淋巴细胞和巨噬细胞增多,有纤维组织增生.结论宫颈癌介入化疗栓塞可有效缓解临床症状,可使癌组织局限,减少术中出血,为中晚期宫颈癌治疗增加根治性手术切除机会,提高手术治疗效果.

Application of Interventional Chemoembolization in Combination with Radical Hysterectomy for Cervical Carcinoma

Objective To evaluate the efficacy of preoperative interventional chemotherapy and chemoembolization via uterine artery for cervical carcinoma in middle-advanced stage.Methods 30 patients with cervical carcinoma diagnosed pathologically who underwent interventional chemoembolization were enrolled into the study,including 24 cases of Ⅱb,4 cases of Ⅲa,and 2 cases of Ⅲb.Results After interventional chemoembolization,angrophy showed that bilateral uterine arteries were obliterated and tumor staining disappeared.And the remission rate of the clinical symptoms was 90%(27/30).30 patients underwent radical hysterectomy after receiving interventional chemoembolization.In the patients,the tumor volume reduced,surface of uterus was pale,adhesions around the tumor were light,the tumor was easily resected,blood loss was reduced.In the postoperative pathological examinations,massive coagulative necrosis and karyolysis of cnacer cell were found,lymphocytes and macrophages increased within the tunor,moreover,the proliferating fibroid connective tissues were found.Conclusions For the treatment of cervical carcinoma in middle-advanced stage,the preoperative interventional chemoembolization can effectively alleviate clinical symptoms,decrease the tumor size and reduce blood loss during operation.It can increase the possibility of radical hysterectomy and perfect outcomes of patients.