| Objective:To discuss the clinical effects of implantation of radioactive 125 I seeds under the guidance of ultrasound in the treatment of abdominal cancer and the applied features of ultrasound in the implantation of radioactive 125 I seeds in the treatment of abdominal cancer.Methods:Searching 142 abdominal malignant tumor patients in our hospital of January,2014 to December,2016.The inclusion criteria are as follows,(1)they were diagnosed as abdominal malignant tumor by pathology or imaging and clinical data,and the didn’t have the opportunity to get excision;(2)no obvious bleeding and coagulation function;(3)no obvious cardiovascular system or cerebrovascular disease.Patients were 42 liver cancer patients,53 pancreatic cancer patients,27 retroperitoneal carcinoma patients and 20 celiac carcinoma patients.There were 86 male patients and 56 female patients,the ages ranged from 28 to 83 years old,the average age was 59.41±11.83 years old.The maximal and minimal length diameter was 15 centimeter and 2 centimeter respectively,the average diameter was 5.26±2.70 cm.The selected patients mainly had pain with diseased and the involved regions,some patients merged with abdominal distension.Counting numbers of patients with pain and following up the changes of pain degrees to judge the station of pain relief.Following up the abdominal ultrasound and CT,contrasting the tumor size of abdominal CT of 3 months after the operation with CT before the operation to evaluate objectively the local control of the operation to tumor.Following up 3 to 33 months,recording the survival of patients to analyze the survival time.Recording the occurrence of complications,including biliary fistula,intestinal fistula,pancreatic fistula,gastrointestinal obstruction,hemorrhage,seroperitoneum,radiation enteritis and so on,to judge the safety and feasibility of the operation.Analyzing and summarizing the applied features of Color Doppler before and in the operation,analyzing the effects of meter set and probe applying skill to operation.Results:(1)Pain relief: Among 142 abdominal tumor patients,the 87 patients with preoperative pain released the symptoms at 2 to 7 days after the operation.Complete relief patients were 59,partial response patients were 17,invalid patients were 11.Pain relief rate of abdominal tumors of different locations were liver cancer 85.71%,pancreatic cancer 90.00%,retroperitoneal carcinoma 85.00%,celiac carcinoma 84.62%,total pain relief rate was 87.35%;(2)Local control of tumor: making comparisons between preoperative and CT images 3 months after the operation.The results were CR 37,PR 71,SD 22,PD 12.Local control of abdominal tumors of different locations were liver cancer 83.33%,pancreatic cancer 73.58%,retroperitoneal carcinoma 70.37%,celiac carcinoma 75.00%,total local control rate was 76.06%;(3)Complications: Of 142 patients,15 patients occurred fever,the temperature were all below 39 degrees.5 patients occurred abdominal distension,5 patients occurred seroperitoneum,2 patients occurred gastric retention.The rate of complications were liver cancer 19.05%,pancreatic cancer 18.87%,retroperitoneal carcinoma 18.52%,celiac carcinoma 20.00%,total pain relief rate was 19.01%.Those complications got remission and recovery.All patients didn’t occur complications that need intervene of surgical methods,including biliary fistula,intestinal fistula,pancreatic fistula,gastrointestinal obstruction,hemorrhage,seroperitoneum,radiation enteritis and so on.Neither do they occur seeds transposition;(4)Medium survival time: following up 3 to 33 months after the operation.All statistical medium survival time were: liver cancer 16 months,pancreatic cancer 11 months,retroperitoneal tumor 13 months,celiac carcinoma 16 months.The total medium survival time was 13 months.The one-year survival survival rates were: liver cancer 75.3%,pancreatic cancer 34.3%,retroperitoneal tumor 52.5%,celiac carcinoma 58.2%.Conclusion:Under the basis of good control of tumor,ultrasonically radioactive 125 I seeds intestinal implantation can prolong the survival time of patients effectively with little complications,which improves the life quality of patients vastly.Especially for those patients who has lost the chance of excision,it was an effective palliative way.As a guidance of implanting radioactive 125 I seeds to abdominal malignant tumors,ultrasound has the advantages of timely presentation,locating accurately,operating simply,without radioactivity and other advantages,cost performance is rather high.To the implantation of radioactive 125 I seeds,ultrasound is a guiding facility with wide application prospect. |
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