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術(shù)中冷凍消融和冷熱復(fù)合消融治療不可切除胰腺癌的臨床研究

The clinical study of intraoperative cryoablation therapy and intraoperative combined cryoablation and hyperthermia in the treatment of unresectable pancreatic cancer

DOI：doi：10.7655/NYDXBNS20210815

中文關(guān)鍵詞: 不可切除胰腺癌  冷熱復(fù)合消融  術(shù)后并發(fā)癥  生存期

英文關(guān)鍵詞: unresectable     pancreatic cancer  intraoperative     combined cryoablation and hyperthermia  postoperative complications  survival rate

基金項(xiàng)目:南京市衛(wèi)生科技發(fā)展專項(xiàng)資金項(xiàng)目一般性課題（YKK18188），南京醫(yī)科大學(xué)科技發(fā)展基金一般項(xiàng)目（NMUB 2019044，NMUB2019045，NMUB2019059，NMUB2019060）

作者：

錢祝銀 南京醫(yī)科大學(xué)第二附屬醫(yī)院胰腺中心，江蘇　南京　210003 

張　彬 南京醫(yī)科大學(xué)第二附屬醫(yī)院胰腺中心，江蘇　南京　210003 

陳奕秋 南京醫(yī)科大學(xué)生理學(xué)系，江蘇　南京　211166 

吳迎春 南京醫(yī)科大學(xué)第二附屬醫(yī)院超聲醫(yī)學(xué)科，江蘇　南京　210003 

顧玉青 南京醫(yī)科大學(xué)第二附屬醫(yī)院胰腺中心，江蘇　南京　210003 

朱一超 南京醫(yī)科大學(xué)生理學(xué)系，江蘇　南京　211166 

中文摘要:

目的：比較術(shù)中冷凍消融（intraoperative cryoablation therapy，IOCT）和冷熱復(fù)合消融（intraoperative combined cryoablation and hyperthermia，ICCH）治療不可切除胰腺癌的安全性和有效性。方法：南京醫(yī)科大學(xué)第二附屬醫(yī)院胰腺中心收治的不可切除胰腺癌患者，分為IOCT組（101例）與ICCH組（35例），分析患者臨床資料，對比手術(shù)方法，分組對比術(shù)后并發(fā)癥發(fā)生率、生存率、腫瘤指標(biāo)及疼痛評分。結(jié)果：與IOCT組相比，ICCH組術(shù)中出血量更少，術(shù)后禁食時(shí)間更短（P < 0.01）。ICCH組術(shù)后并發(fā)癥發(fā)生率、嚴(yán)重程度均低于IOCT組（P < 0.05）。胰頭癌患者術(shù)后1年內(nèi)的生存率，ICCH組顯著高于IOCT組（P=0.034）。結(jié)論：ICCH較IOCT對不可切除胰腺癌的治療效率更高，風(fēng)險(xiǎn)更小，并發(fā)癥發(fā)生率更低。

英文摘要:

Objective：To comparethe therapeutic efficiency and risk of intraoperative cryoablation therapy（IOCT）and intraoperative combined cryoablation and hyperthermia（ICCH）in the treatment of unresectable pancreatic cancer. Methods：Patients with unresectable pancreatic cancer admitted to the Pancreatic Center of the Second Affiliated Hospital of Nanjing Medical University were divided into two groups：IOCT group（101 cases）and ICCH group（35 cases）. The clinical data of patients were analyzed and surgical methods were compared. The incidence of postoperative complications，survival rate，tumor indexes and pain scores were compared in groups. Results：Compared with IOCT group，the intraoperative blood loss was less in ICCH group（P < 0.01）. The postoperative fasting time in ICCH group was shorter than that in IOCT group（P < 0.01）. The incidence and severity of postoperative complications in ICCH group were lower than those in IOCT group（P < 0.05）. The 1?year survival rate of patients with pancreatic head carcinoma was significantly higher in ICCH group than in IOCT group（P=0.034）. Conclusion：ICCH is more effective in the treatment of unresectable pancreatic cancer，with lower risk and lower complication rate than IOCT.