摘要
目的探讨经导管动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗晚期喉癌所致急性出血和呼吸困难的疗效及安全性。方法回顾性分析重庆市东南医院及重庆大学附属肿瘤医院2019年8月至2024年8月收治的45例晚期喉癌所致急症患者的临床资料,根据患者的治疗方式分为对照组(n=21)和观察组(n=24),对照组患者以常规治疗为主,观察组患者以TACE治疗为主,主要观察指标:止血成功率、呼吸困难缓解率、TACE治疗有效性及安全性。次要观察指标:肿瘤客观缓解率(objective response rate,ORR)。结果观察组止血疗效明显优于对照组(χ^(2)值16.238,P<0.001)。对照组中有15例合并出血,经内科治疗后仅2例临床完全缓解、4例有效、9例无效,无效的患者中3例于1个月内死亡;观察组中合并出血19例,15例临床完全缓解、2例有效、2例无效。观察组对呼吸困难的缓解也有明显获益(χ^(2)值14.730,P<0.001)。观察组术后有发热、甲状腺功能减退、舌体溃疡等不良反应,无3~4级不良反应。1个月后随访,对照组部分缓解(PR)2例(9.5%),疾病稳定(SD)8例(38.0%),疾病进展(PD)8例(38.0%),有3例患者因大出血死亡,ORR为9.5%;观察组PR 14例(58.3%),SD 8例(33.3%),PD 2例(8.4%),其中2例因肿瘤进展所致恶病质临床死亡,ORR为58.3%。结论TACE在晚期喉癌所致急性出血和呼吸困难的诊疗中是一种有效、安全的诊疗方法,也可有效控制局部肿瘤。
Objective To evaluate the effectiveness and safety of transcatheter arterial chemoembolization(TACE)in treating acute hemorrhage and dyspnea induced by advanced laryngocarcinoma.Methods A retrospective analysis was performed on 45 patients with advanced laryngeal carcinoma admitted to Chongqing Southeast Hospital and the Affiliated Cancer Hospital of Chongqing University from August 2019 to August 2024.According to the patient′s treatment method,they were divided into control group(n=21)with traditional medical treatment and observation group(n=24)with TACE.Main observational indexes were successful rate of hemostasis,remission rate of dyspnea,the effectiveness and safety of TACE.Secondary observational indexes were tumor objective response rate(ORR).Results The therapeutic effect in the observation group was significantly better compared with control group(χ^(2) value 16.238,P<0.001).In the control group,15 of 21 patients had bleeding,only 2 cases achieved complete remission,4 cases were evaluated to be effective,9 cases were ineffective,and 3 cases died within 1 month.In the observation group,19 of 24 patients had hemorrhage after TACE,15 cases achieved complete remission,2 cases were evaluated to be effective,2 cases were ineffective.The observation group was treated with TACE to control dyspnea,and the therapeutic effect was significantly better compared with control group(χ^(2) value 14.730,P<0.001).The observation group experienced adverse reactions such as fever,hypothyroidism and tongue ulcers after surgery,but had no grade 3-4 adverse reactions.Following up after one month,there were 2 cases(9.5%)of partial response(PR),8 cases(38.0%)of disease stability(SD),8 cases(38.0%)of disease progression(PD),3 dead patients due to massive hemorrhage and 9.5%ORR in the control group.There were 14 cases(58.3%)of PR,8 cases(33.3%)of SD,2 cases(8.4%)of PD,2 dead patients due to cachexia caused by tumor and 58.3%ORR in the observation group after surgery.Conclusions TACE is an effective and safe emergency treatment for advanced-laryngocarcinoma-associated acute hemorrhage and dyspnea,and also has certain therapeutic effects on local tumors.
作者
李华
龙行涛
肖洪波
陈金莎
万灵湘
郑晓敏
金福军
Li Hua;Long Xingtao;Xiao Hongbo;Chen Jinsha;Wan Lingxiang;Zheng Xiaomin;Jin Fujun(The Oncology Department,Chongqing Southeast Hospital,Chongqing 401336,China)
出处
《中国急救医学》
2025年第3期199-204,共6页
Chinese Journal of Critical Care Medicine
基金
重庆市卫生健康委医学科研项目(2023WSJK061)
重庆市科技局项目(2024NSCQ-MSX1295)。
关键词
喉癌
经导管动脉化疗栓塞术
出血
呼吸困难
Laryngocarcinoma
Transcatheter arterial chemoembolization(TACE)
Hemorrhage
Dyspnea
