胃癌伴呕血术前介入治疗的临床观察

目的探讨胃癌伴呕血术前化疗栓塞的疗效、不良反应及对手术切除率的影响。方法胃癌伴呕血患者45例,分为化疗栓塞后手术组和单纯手术组。化疗栓塞后手术组20例,测量化疗栓塞后其大小、形态的变化,肿瘤坏死的程度及不良反应,7~15 d后行手术切除,统计手术时间、术中出血量、手术切除率及生存时间,并与单纯手术组25例进行比较。结果化疗栓塞可使呕血消失、肿瘤发生一定程度的坏死,并使病变范围有所缩小,不良反应轻微。化疗栓塞后再行手术切除,不仅可提高手术切除率,还可减少手术时间及术中出血量,延长了生存时间。结论胃癌伴呕血术前化疗栓塞,创伤轻微,疗效显著,应作为术前的一项常规治疗手段。

Clinical observation of the preoperative interventional therapy for stomach cancer with hematemesis

Objective To study the efficacy and adverse reaction of the preoperative interventional chemotherapy and embolization in treatment of stomach cancer with hematemesis and the effect on rate of excision of the cancer.Methods Forty-five cases were divided into two groups: interventional chemotherapy-embolization and operation group and simple operation group.The interventional chemotherapy-embolization and operation group included 20 cases.The changes in size shape,grade of tumor necrosis and adverse reaction after chemotherapy embolism were measured.Operation removal was performed after 7 to 15 days.The time of operation,bleeding during operation,the rate of operation excision survival time were studied and compared with simple operation group which included 25 cases.Results Chemotherapy-embolization could cause disappearance of hematemesis,the tumour necrosis and reduce the range of the pathological changes and adverse reaction.Operation excision after chemotherap-embolization not only increased the rate of operation excision but also decreased the time of operation and bleeding during operation and prolonged the survival time.Conclusion Preoperative interventional chemotherapy-embolization of cancer with hematemesis causes little hurt and remarkable therapeutic effectiveness.It should be used as a routine treatment measure.