结肠癌肝转移应用聚乙烯醇载药微球介入栓塞的临床效果

摘要/Abstract

摘要： 目的探讨结肠癌肝转移应用聚乙烯醇载药微球介入栓塞的临床效果。方法研究对象选取2020年1月到2021年1月间眉山市中医医院收治的结肠癌肝转移患者86例。采用随机数字法将其分为对照组和试验组,各43例。对照组采用传统栓塞治疗(碘化油+表柔比星)治疗,试验组采用新型栓塞治疗(聚乙烯醇载药微球+表柔比星)治疗。比较两组治疗后肝功能水平、肿瘤坏死率、临床疗效、不良反应。结果试验组疾病缓解率、疾病控制率分别为79.07%(34/43)、95.35%(41/43)。对照组疾病缓解率、疾病控制率分别为51.16%(22/43)、88.37%(38/43)。试验组疾病缓解率、肿瘤坏死率显著高于对照组,差异均具有统计学意义(P<0.05)。试验组患者ALT、AST、Alb水平分别为(35.39±7.65)U/L、(36.87±7.68)U/L、(38.21±7.54)g/L。对照组患者ALT、AST、Alb水平分别为(48.14±10.36)U/L、(50.24±11.54)U/L、(31.24±6.47)g/L。试验组患者ALT、AST水平均显著低于对照组,试验组患者Alb水平显著高于对照组,差异均具有统计学意义(P<0.05)。试验组消化道反应、腹痛、发热的发生率均显著低于对照组,差异均具有统计学意义(P<0.05)。结论结肠癌肝转移应用聚乙烯醇载药微球介入栓塞,可有效提高肿瘤坏死率、疾病缓解率,保护肝脏功能,降低不良反应。

关键词: 聚乙烯醇载药微球, 介入栓塞, 结肠癌肝转移

Abstract: Objective To investigate the clinical effect of embolization with polyvinyl alcohol-loaded microspheres for liver metastases from colon cancer. Methods Eighty-six patients with liver metastases from colon cancer who were admitted from January 2020 to January 2021 were selected as the study subjects. They were divided into a control group and an experimental group by random number method, each with 43 cases. The control group was treated with traditional embolization therapy (lipiodol in combination with epirubicin), and the experimental group was treated with new embolization therapy (polyvinyl alcohol drug-loaded microspheres in combination with epirubicin). Liver function levels, tumor necrosis rate, clinical efficacy, and adverse reactions were compared between these two groups of patients after treatment. Results The disease remission rate and disease control rate of the experimental group were 79.07% (34/43) and 95.35% (41/43), respectively. The disease remission rate and disease control rate of the control group were 51.16% (22/43) and 88.37% (38/43), respectively. The disease remission rate and tumor necrosis rate of the experimental group were significantly higher than those of the control group (P<0.05). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin (Alb) in the experimental group were (35.39±7.65) U/L, (36.87±7.68) U/L, and (38.21±7.54) g/L, respectively. The levels of ALT, AST and Alb in the control group were (48.14±10.36) U/L, (50.24±11.54) U/L, and (31.24±6.47) g/L, respectively. The levels of ALT and AST in the test group were significantly lower than those in the control group, and the Alb levels in the test group were significantly higher than those in the control group (P<0.05). The incidence of gastrointestinal reactions, abdominal pain, and fever in the test group were significantly lower than those in the control group (P<0.05). Conclusion Interventional embolization with polyvinyl alcohol-loaded microspheres for liver metastases from colon cancer can effectively increase tumor necrosis rate, disease remission rate, protect liver function, and reduce adverse reactions.

Key words: Polyvinyl alcohol drug-loaded microspheres, Interventional embolization, Colon cancer liver metastasis

刘丽, 陈嘉兵, 陈成. 结肠癌肝转移应用聚乙烯醇载药微球介入栓塞的临床效果[J]. 肝脏, 2022, 27(2): 185-187.

LIU Li, CHEN Jia-bing, CHEN Cheng. Clinical effect of embolization with polyvinyl alcohol-loaded microspheres for liver metastases from colon cancer[J]. Chinese Hepatolgy, 2022, 27(2): 185-187.

参考文献

[1] 邹富年, 李柏峰. 结肠癌肝转移的治疗进展. 中华肝胆外科杂志, 2017,5:53-55.
[2] 常文举, 任黎, 许剑民. 2019年结直肠癌肝转移诊疗指南最新解读. 中国普外基础与临床杂志, 2019,3:335-336.
[3] 徐文杰, 曹刚, 张根山,等. 聚乙烯醇栓塞微球可载药微球介入治疗中晚期肝癌的临床疗效及安全性观察. 实用癌症杂志, 2017, 12:89-91.
[4] 中华医学会外科学分会胃肠外科学组, 中华医学会外科学分会结直肠肛门外科学组, 中国抗癌协会大肠癌专业委员会,等. 结直肠癌肝转移诊断和综合治疗指南(2016). 中国实用外科杂志, 2016,7:75-76.
[5] 孙志德, 程利民. 结肠癌肝转移患者临床病理因素对预后的影响. 河北医学, 2019, 25:1151-1154.
[6] 刘德华, 魏宏, 王少雷. 肝动脉灌注化疗栓塞与全身静脉化疗治疗结肠癌肝转移疗效比较. 中国现代手术学杂志, 2016, 20:259-262.
[7] 阳扬, 陈建思, 赖洁,等. 90例无法手术切除的结肠癌肝转移病例的介入治疗分析. 中国全科医学, 2017,6:170-172.
[8] 王保信, 邢宏建. 经肝动脉栓塞化疗治疗结肠癌肝转移患者临床初步研究. 实用肝脏病杂志, 2017,6:202-205.
[9] 赵邦利, 崔新江, 邢辉,等. 碘化油联合微球经导管肝动脉化疗栓塞治疗大肝癌效果观察. 山东医药, 2018, 58:87-89.
[10] 黄文浩, 冯广森. 聚乙烯醇载药微球介入栓塞治疗原发性肝癌的临床分析. 实用肿瘤杂志, 2020, 35:74-78.
[11] Cao Y L, Ding YY, Zhang LP, et al. Preparation of surface-modified, micrometer-sized carboxymethyl chitosan drug-loaded microspheres. J Appl Polym Sci, 2018,135:45731.
[12] 廖囡囡, 杨旭霞, 吴丽娟,等. 聚乙烯醇微球的制备与表征. 材料科学与工程学报, 2018, 36:54,80-84.
[13] Ghosal K D, Ghosh, Das S K. Preparation and evaluation of naringin-loaded polycaprolactone microspheres based oral suspension using Box-Behnken design. J Mol Liq, 2018, 2:49-57.
[14] 宋寄春, 韩束平. 聚乙烯醇肝动脉栓塞介入治疗晚期肝癌合并上消化道出血的临床观察. 实用癌症杂志 2019,34:1621-1624.
[15] 李志坚, 海军. 晚期肝癌合并上消化道出血的聚乙烯醇肝动脉栓塞介入治疗价值. 肝脏, 2017,6:42-45.
[16] 罗文苹, 王国栋. 应用碘油和8Spheres聚乙烯醇栓塞微球联合明胶海绵行经导管动脉化疗栓塞术治疗大肝癌的临床效果观察. 广西医学, 2020,9:89-91.