简介:目的:探讨125↑I粒子植入治疗复发性恶性肿瘤的疗效及安全性。方法:31例复发性恶性肿瘤患者,男22例,女9例,年龄19岁-76岁,平均51岁,其中脑胶质瘤1例,鼻咽癌4例,鼻窦癌2例,口咽癌2例,食道癌3例,肺癌5例,乳腺癌1例,肝癌4例,直肠癌3例,宫颈癌1例,骨肉瘤3例,纤维肉瘤2例,31例共36个病灶。在CT或B超引导下将125I粒子植入肿瘤病灶内,采用放射性粒子治疗计划系统(TPS)设计布源,将放射性活度为23.31MBq-29.97MBq的125I粒子按10mm层间距植入。结果:31例36个病灶,完全缓解(CR)8个,部分缓解18个,总有效率72.2%。术中11例出现少量渗血;术后出现胸背痛1例,1例出现少量气胸(肺压缩小于30%),保守治疗后恢复;食道气道瘘1例。结论:125I粒子植入作为常规放化疗治疗复发性恶性肿瘤的一种补充治疗手段,局部控制率高,创伤小,安全性好。
简介:Objective:Toanalyzetheclinicopathologiccharacteristicsandprognosticfactorsofsmallgastrointestinalstromaltumor(GIST)ofthestomach.Methods:Atotalof31smallgastricGISTpatients,including10malesand21females,withamedianageof58years(37-81years),whounderwentsurgeryatanytimefrom1999to2012wereincludedinthisstudy.Theclinicalrecordsofthepatientswereanalyzedretrospectively.Results:Abdominaldiscomfortandpain(10cases,32.3%,respectively)werethetwomostcommoncomplaintsamongthepatients.Allpatientsreceivedsurgery,11receivedgastricwedgeresection,11receivedsubtotalgastrectomy,5receivedlaparoscopicgastricwedgeresection,and4receivedendoscopicsubmucosaldissection.Nosevereadversecomplicationwasobserved.Atotalof29patients(93.5%)werefollowedup.Duringthefollow-up,2patientswerefoundtoexhibittumorrecurrence,and1patienthadlivermetastases.Onepatientdiedoftumorprogression,whileanotherdiedofanothermalignanttumor.Medianprogressionfreesurvival(PFS)timewas120.3months,andmedianoverallsurvival(OS)timewas130.4months.Conclusion:SmallgastricGISThasbetterprognosis.Surgeryisthebestchoicefortherapy.Micro-invasiveproceduresaresafeandeffectiveforelectivepatients.Tumornecrosis,tumorbleeding,andmuscleinvasionarepotentialprognosticfactorsofsmallgastricGIST.
简介:目的比较有限切开钛缆捆扎辅助股骨近端髓内钉(proximalfemoralnailantirotation,PFNA)与单纯微创辅助PFNA治疗老年骨质疏松性31-A3型股骨粗隆间骨折患者的临床疗效。方法对2014年1月至2017年1月我院收治的46例老年31-A3型股骨粗隆间骨折患者,分别采用钛捆扎辅助PFNA(A组,23例)与骨拨或复位钳等辅助PFNA治疗(B组,23例),对比分析两组的手术时间、术中出血量、术后6个月起立行走情况,术后并发症发生率,两组骨折愈合时间及术后髋关节功能评分情况。结果两组获平均25.4(12~32)个月随访,切口均一期愈合,无感染、血管神经损伤,无下肢深静脉血栓形成、脂肪栓塞。两组骨折愈合时间(A组平均7.5个月,B组平均7.6个月)、术后末次随访髋关节功能评分(harrishipscore,HHS)(A组平均82.6分,B组平均81.1分),两组相比差异无统计学意义(P=0.445);手术时间、术中出血量、术后6个月起立行走测试(timeupandgtest,TUG)、术后并发症发生率,两组相比差异均有统计学意义(P<0.05),A组优于B组。结论对老年骨质疏松性31-A3型股骨粗隆间骨折采取钛缆捆扎辅助治疗可降低骨折复杂程度及手术难度、可使患者早期下地活动、减少术后并发症的发生。