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目的观察动脉插管介入治疗对于中晚期宫颈癌患者肿瘤瘤体缩减及临床期别的提高情况,从而增加手术机会。方法对IIa~IVa期宫颈癌36例,采用Seldinger技术、经皮股动脉穿刺插管术,在X线电视等放射仪器监视下加压将5~6 F导管选择性插入髂内动脉后,先行动脉造影,以了解血管分布,肿瘤动脉供血及侧支循环等情况,一侧髂内动脉灌注化疗药物半量后,用明胶海绵栓塞血管,同法注入对侧髂内动脉化疗药物半量,栓塞血管,拔管,包扎穿刺部位6 h,以防止穿刺部位出血,形成血肿。结果宫颈癌症状缓解率100%,其中,明显缓解率78%,部分缓解率22%。临床有效率91%,CR 6例,PR 27例,NC 3例。30例顺利完成手术,13例术后免除放疗。结论对于中晚期宫颈癌患者给予子宫动脉插管介入和栓塞治疗不但可以缩小瘤体,同时可以改善临床期别,增加手术机会,从而提高生存率。
Objective To observe the interventional treatment of arterial intubation for advanced cervical cancer in patients with tumor shrinkage and improve the clinical stage, thereby increasing the chance of surgery. Methods Thirty-six patients with stage IIa-IVa cervical cancer were treated with Seldinger technique and percutaneous femoral artery puncture and catheterization. The 5-6 F catheter was selectively inserted into the internal iliac artery under the surveillance of radiological instruments such as X-ray television. Arterial angiography in order to understand the vascular distribution, tumor artery blood supply and collateral circulation and other circumstances, one side of the iliac artery after half the amount of chemotherapy drugs, with gelatin sponge embolization of blood vessels, the same method into the contralateral iliac artery chemotherapy drugs half the amount of embolization of blood vessels, Extubation, dressing puncture site 6 h, to prevent the puncture site bleeding, the formation of hematoma. Results The rate of cervical cancer remission was 100%, of which 78% was significantly relieved and 22% partially relieved. Clinical efficiency of 91%, CR 6 cases, PR 27 cases, NC 3 cases. Thirty patients successfully completed the operation and 13 patients were given radiotherapy. Conclusions Interventional and embolization of uterine artery with uterine artery in patients with advanced cervical cancer not only can reduce the size of the tumor, but also improve the clinical stage, increase the chance of operation and improve the survival rate.