Sedation Analgesia Under High Intensity Focused Ultrasound Treatment Of Advanced Pancreatic Cancer Clinical Observation

Objective Analysis under sedation analgesia unresectable pancreaticcancer surgery the curative effect of high intensity focused ultrasoundtreatment, complications, a preliminary comparative evaluation undersedation analgesia with low power high intensity focused ultrasoundtreatment in such patients, the safety and effectiveness.Methods Collected in January2010-December2013at Shanghai’sfudan university affiliated tumor hospital sedation analgesia under highintensity focused ultrasound treatment of44cases of pancreatic cancerpatients, divided into A (100-300w), B (350-400w) two groups andcompared before and after treatment in patients with biochemical indicatorsof change, after the treatment of related adverse reactions, painkillerstaking the changes of the patients complained of pain before and after thetreatment, treatment after3months of imaging, and postoperativefollow-up survival conditions and survival quality.Results For A, B two groups of patients in this study were performedserum amylase, C-reactive protein, CA19-9difference before and after surgery were compared. A group of patients4.54%(1/22) after a transientincrease in serum amylase, group B22.72%(5/22) postoperative serumamylase; A group of patients81.82%(18/22) postoperative C-reactiveprotein,90.91%of patients in group B (20/22) postoperative C-reactiveprotein; A group of patients63.64%(14/22) with varying degrees of tumormarkers CA19-9decreased68.18%of patients in group B (15/22) withvarying degrees of tumor markers dropped CA19-9. The two groups wereCA19-9decreased amount rank test shows P>0.05, so no significantdifference. A group31.82%(7/22) of patients had transient postoperativefever, body temperature>38℃, can be restored to normal within two hours,group B54.55%(12/22) of patients had transient postoperative fever, bodytemperature>38℃, can be restored within six hours of normal; A group54.55%(12/22) in patients with postoperative pain, the most obvious afterabout3hours to5hours or so gradually improved, group B72.27%(17/22)in patients with postoperative pain, most notably after about3hours to8hours or so gradually improved; A group of patients before and aftersurgery abdominal skin did not change significantly in group B13.63%(3/22) of patients with skin redness, skin temperature is higher, givingintermittent ice two hours after remission; A group of all patients and nocase (0/22) with acute pancreatitis, group B9.09%(2/22) in patients withacute pancreatitis, postoperative hematuria starch enzymes increasedsignificantly, related to treatment after his condition improved. All cases no acute peritonitis, bleeding tumors, pancreatic leakage or seriouscomplications such as perforation of the digestive tract. A group of9.09%(2/22) in patients with clinical evaluation of PR,27.27%(6/22) Clinicalevaluation of PD,54.55%(12/22) Clinical evaluation of SD,9.09%(2/22)in after treatment in the March death, did not obtain relevant information;clinical evaluation of group B13.64%(3/22) patients PR,18.18%(4/22)clinical evaluation of PD,63.64%(14/22) the clinical efficacy of SD,4.55%(1/22) of patients died after3months of treatment, did not get theinformation. After surgical treatment A, B groups complained of pain inpatients with varying degrees of ease, Group A pain response rate(complete response+partial response) was75.00%, group B72.73%painrelief, the patient complained of pain between the two groups before andafter treatment the amount of change taking painkillers rank test shows P>0.05and therefore no significant difference between the two groups. Amedian survival was6.4months, group B, median survival was6.95months, with clinical studies6.8-month median survival of the basicagreement, survival time test shows P>0.05prompted no significantdifference.Conclusions Sedation and analgesia high intensity focused ultrasoundtreatment of unresectable pancreatic cancer surgery can significantly reducepain symptoms, effective inactivation of cancer cells, to some extent, can effect was found under different power after the next lower power HIFUpatients better tolerated, complications lower case, and both pain relief,with a median survival of CA19-9and no significant difference in terms ofdecline. Therefore, under sedation analgesia high intensity focusedultrasound in the treatment of pancreatic cancer is lower in patients withadvanced power is a better treatment.