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[目的]探讨射频消融治疗不能切除的胰体尾癌的适应证。[方法]对手术不能切除的15例胰体尾癌行术中射频热疗。自2005年起对8例(A组)患者严格按照自身总结的适应证进行操作,对比2005年之前射频热疗7例(B组),观察生化指标、并发症、疼痛及生存情况。[结果]部分病例病理活检为凝固坏死改变,术后CT为高密度改变,B超为高回声改变。所有病例均无出血、感染、胰瘘并发症发生。2005年后行射频热疗8例患者,较之前的7例患者术后血清及腹腔引流液淀粉酶、CA19-9下降显著,腹痛分级好转明显。所有病例平均随访18个月,2例死亡,13例带瘤生存。[结论]按照适应证射频消融治疗晚期胰体尾癌能有效提高治疗效果及生存质量。
[Objective] To investigate the indications of radiofrequency catheter ablation for unresectable pancreatic body tail cancer. [Method] The intraoperative radiofrequency thermotherapy was performed on 15 patients with unresectable pancreatic body cancer. Since 2005, 8 patients (group A) operated strictly in accordance with their own indications. Compared with 7 cases before radiotherapy (group B) before 2005, biochemical indexes, complications, pain and survival were observed. [Results] The pathological biopsy in some cases was the change of coagulation necrosis. The postoperative CT was high density and the B ultrasound was hyperechoic. No cases of bleeding, infection, complications of pancreatic fistula occurred. After radiotherapy in 2005 8 patients, compared with the previous 7 patients with postoperative serum and peritoneal drainage amylase, CA19-9 decreased significantly, the grade of abdominal pain improved significantly. All patients were followed up for an average of 18 months, 2 died and 13 survived. [Conclusion] Radiofrequency catheter ablation in the treatment of advanced pancreatic body and tail cancer can effectively improve the therapeutic effect and quality of life.