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目的:探讨自凝刀对于不能行手术治疗的巨块型Ⅱ_bⅢ_b期宫颈癌的临床研究价值。方法:将Ⅱ_bⅢ_b期宫颈癌病人,随机分为两组:(1)自凝刀+常规放疗组(试验组)(2)常规放疗组(对照组)。治疗过程:试验组的病人,在放疗前1天(即行消菜花量的首次后装治疗时间)在B超监视下,用自凝刀将宫颈癌块祛除,瘤体在3～5个cm~3者,用中号刀插植治疗1次。大于5cm~3者,用大号刀连续插植2次～3次,每次播植治疗时间10分钟～20分钟,直至肿瘤完全气化为止。治疗后次日行常规放疗,并每日阴道冲洗1次,1周后,凝固气化坏死肿瘤完全脱离,暴露宫颈原形。结果:(1)两组生存率:试验组97.5％,对照组95％(X~2=0.35 P>0.05)无显著差异。(2)放射性直肠炎的发生率:试验组是7.5％(3/40),对照组是22.5％(9/40),两组比较差异有显著性(X~2=3.85 P<0.05);(3)放射性膀胱炎的发生率:试验组是5％(2/40),对照组是20％(8/40),两组比较差异有显著性(X~2=4.11 P<0.05);(4)住院时间:试验组7周～8周,对照组9周～10周。结论本方法治疗晚期巨块型宫颈癌,既降低了放疗并发症,缩短了住院时间,省时省力方便易行。
Objective: To investigate the clinical value of self-coagulation knife for giant block Ⅱ_bⅢ_b cervical cancer that can not be surgically treated. Methods: Patients with stage Ⅱ_bⅢ_b cervical cancer were randomly divided into two groups: (1) self-coagulation knife + conventional radiotherapy group (experimental group); (2) conventional radiotherapy group (control group). The course of treatment: patients in the test group, 1 day before radiotherapy (that is, the first time after the decoction spent after the treatment time) in the B-monitor, with self-coagulation knife will remove the cervical mass, the tumor in 3 ~ 5 cm ~ 3, with a medium knife implants 1 treatment. More than 5cm ~ 3, with a large knife inserted 2 to 3 times in succession, each sowing treatment time of 10 minutes to 20 minutes until the tumor completely gasified so far. The next day after treatment routine radiotherapy, and daily vaginal washing 1, 1 week after coagulation gasification necrosis tumor completely detached, exposing the cervix prototype. Results: (1) Survival rate of the two groups was 97.5% in the experimental group and 95% in the control group (X ~ 2 = 0.35 P> 0.05). (2) The incidence of radiological proctitis was 7.5% (3/40) in the test group and 22.5% (9/40) in the control group. There was significant difference between the two groups (X ~ 2 = 3.85 P <0.05). (3) The incidence of radiation cystitis was 5% (2/40) in the test group and 20% (8/40) in the control group. There was significant difference between the two groups (X ~ 2 = 4.11 P <0.05). (4) Hospitalization time: experimental group 7 weeks to 8 weeks, control group 9 weeks to 10 weeks. Conclusion The method of treatment of advanced giant cervical cancer, not only reduce the radiotherapy complications, shorten the hospitalization time, saving time and labor easily.