术中冷冻消融和冷热复合消融治疗不可切除胰腺癌的临床研究

The clinical study of intraoperative cryoablation therapy and intraoperative combined cryoablation and hyperthermia in the treatment of unresectable pancreatic cancer

DOI：doi：10.7655/NYDXBNS20210815

中文关键词: 不可切除胰腺癌  冷热复合消融  术后并发症  生存期

英文关键词: unresectable     pancreatic cancer  intraoperative     combined cryoablation and hyperthermia  postoperative complications  survival rate

基金项目:南京市卫生科技发展专项资金项目一般性课题（YKK18188），南京医科大学科技发展基金一般项目（NMUB 2019044，NMUB2019045，NMUB2019059，NMUB2019060）

作者：

钱祝银 南京医科大学第二附属医院胰腺中心，江苏　南京　210003 

张　彬 南京医科大学第二附属医院胰腺中心，江苏　南京　210003 

陈奕秋 南京医科大学生理学系，江苏　南京　211166 

吴迎春 南京医科大学第二附属医院超声医学科，江苏　南京　210003 

顾玉青 南京医科大学第二附属医院胰腺中心，江苏　南京　210003 

朱一超 南京医科大学生理学系，江苏　南京　211166 

中文摘要:

目的：比较术中冷冻消融（intraoperative cryoablation therapy，IOCT）和冷热复合消融（intraoperative combined cryoablation and hyperthermia，ICCH）治疗不可切除胰腺癌的安全性和有效性。方法：南京医科大学第二附属医院胰腺中心收治的不可切除胰腺癌患者，分为IOCT组（101例）与ICCH组（35例），分析患者临床资料，对比手术方法，分组对比术后并发症发生率、生存率、肿瘤指标及疼痛评分。结果：与IOCT组相比，ICCH组术中出血量更少，术后禁食时间更短（P < 0.01）。ICCH组术后并发症发生率、严重程度均低于IOCT组（P < 0.05）。胰头癌患者术后1年内的生存率，ICCH组显著高于IOCT组（P=0.034）。结论：ICCH较IOCT对不可切除胰腺癌的治疗效率更高，风险更小，并发症发生率更低。

英文摘要:

Objective：To comparethe therapeutic efficiency and risk of intraoperative cryoablation therapy（IOCT）and intraoperative combined cryoablation and hyperthermia（ICCH）in the treatment of unresectable pancreatic cancer. Methods：Patients with unresectable pancreatic cancer admitted to the Pancreatic Center of the Second Affiliated Hospital of Nanjing Medical University were divided into two groups：IOCT group（101 cases）and ICCH group（35 cases）. The clinical data of patients were analyzed and surgical methods were compared. The incidence of postoperative complications，survival rate，tumor indexes and pain scores were compared in groups. Results：Compared with IOCT group，the intraoperative blood loss was less in ICCH group（P < 0.01）. The postoperative fasting time in ICCH group was shorter than that in IOCT group（P < 0.01）. The incidence and severity of postoperative complications in ICCH group were lower than those in IOCT group（P < 0.05）. The 1?year survival rate of patients with pancreatic head carcinoma was significantly higher in ICCH group than in IOCT group（P=0.034）. Conclusion：ICCH is more effective in the treatment of unresectable pancreatic cancer，with lower risk and lower complication rate than IOCT.