术前介入治疗预防胃癌术后复发的疗效评价

目的]探讨术前介入治疗预防胃癌术后复发的临床意义。方法]74例可根治性手术切除的胃癌患者分为两组,一组在根治性切除术前行经胃动脉灌注化疗(GAI)或经胃动脉灌注化疗栓塞(GAI GAE)．另一组直接行根治性切除术，观察介入治疗后患者的临床反应，比较两组患者术后相同时间复发率的差异。结果]22例术前行GAI治疗的患者出现一过性恶心、呕吐，14例行GAI GAE治疗的患者恶心、呕吐较重，有4例出现黑便．经保守治疗后症状消失；36例术前介入治疗的患者术后6、12、18、24个月的复发率分别为0、2．8％、11．1％、25．0％，38例直接行根治性切除术的患者分别为5．3％、10．5％、23．7％、39．5％，两组患者术后远期复发率存在显著差异。结论]胃癌切除前行介入治疗(胃动脉灌注化疗或胃动脉灌注化疗栓塞)安全有效．对减少术后复发有显著的临床效果．值得推广．

The Effect of Preoperative Interventional Therapy on The Patients with Gastric Carcinoma

To investigate the significance of pre-operative intervention against the gastric carcinoma recurrence after operation.Seventy-four cases with gastric carcinoma were divided into two groups,group A accepted gastric arterial influsion(GAI)or GAI+gastric arterial embolization(GAE)before radical gastrectomy,group B received radical gastrectomy only.The clinical response and the recurrent rate were compared between two groups.Twenty-two cases with chemotherapy(GAI)had transient nausea and vomiting.Fourteen patients represented nausea and vomiting more seriously after treatment of GAI+GAE.All patients recovered with conservative treatment.Thirty-six patients with pre-operative interventional therapy were recurrent following operation.The recurrent rates were0/36at6months,1/36at12months,4/36at18months,and9/36at24months,respectively.Of38cases group B,15cases were recurrent within two years following operation.The recurrence rates were2/38at6months,4/38at12months,9/38at18months,and15/38at24months.The recurrent rates between two groups were significantly different(P<0.05).Conclusion]Pre-operative interventional therapy is safe and effective because it can significantly decrease recurrent rate after operation without severe complications.