目 录
中文摘要 (1)
英文摘要 (2)
时间的英文缩写
英文缩写 (3)
研究论文胰十二指肠切除术联合腹腔热灌注技术治疗胰头癌的临床效果评价
前言 (5)
材料与方法 (7)
结果 (12)
讨论 (21)
结论 (27)
50度灰在线播放
参考文献 (27)
综述腹腔热灌注化疗治疗晚期胰腺癌的临床研究进展 (32)
致谢 (39)
个人简历 (40)
胰十二指肠切除术联合腹腔热灌注技术治疗胰头癌的
临床效果评价
摘 要
目的：胰腺癌预后不良，根治术后复发率仍高。腹腔热灌注技术凭借高温杀伤、机械冲刷肿瘤细胞的特性，已于晚期胰腺癌患者的治疗方案中取得良好效果，但目前鲜有腹腔热灌注技术应用于可切除胰头癌的临床研究。本研究旨在于评价胰十二指肠切除术联合腹腔热灌注技术治疗胰头癌的安全性和有效性。
方法：
本研究回顾性分析2017年7月至2019年12月就诊于我中心接受胰十二指肠切除术的胰头癌患者数据，
其中胰十二指肠切除术组（PD）29例，胰十二指肠切除术联合腹腔热灌注组（PD+IPHP）28例。PD+IPHP 组患者分别于术中、术后第2天和术后第4天接受腹腔热灌注治疗，灌注液采用温热生理盐水。观察记录患者术后并发症发生情况和生存情况。
结果：PD+IPHP组和PD组患者术后主要并发症发生率无统计学差异。PD+IPHP组中位总生存期为19.0个月，术后1年生存率为82.35%，2年生存率为49.41%。PD组中位总生存期为13.0个月，术后1年生存率为51.00%，2年生存率为27.33%（Log Rank检验，P=0.030；Breslow检验，P=0.039）。Cox 比例风险模型结果显示腹腔热灌注治疗为影响胰头癌患者生存情况的独立因素（P=0.038；HR=0.363，95% CI: 0.14 - 0.94）。
结论：
腹腔热灌注技术显著延长了胰头癌根治术后患者的总生存期，且并未增加患者术后吻合口漏和其它并发症的发生率，可以在临床上推广应用。
关键词：胰十二指肠切除术，胰腺癌，腹腔热灌注
Pancreatoduodenectomy plus Intraperitoneal Hyperthermic
Perfusion for Pancreatic Head Cancer:Analysis of Clinical
Outcomes
寻思是什么意思ABCTRACT风姿绰约什么意思
Objective: Pancreatic cancer is one of the most malignant tumors with poor prognosis in the digestive system and has a propensity to relap in many patients even after radical surgery. Intraperitoneal hyperthermic perfusion (IPHP) has the characteristics of high-temperature killing and mechanical flushing of tumor cells. IPHP has been applied to the treatment of advanced pancreatic cancer patients and achieved excellent results but infrequently reported in treating rectable pancreatic cancer. This study aimed to evaluate the safety and efficacy of pancreaticoduodenectomy plus intraperitoneal hyperthermic perfusion (PD + IPHP) in patients with pancreatic head cancer.
Methods：
From July 2017 to December 2019, data of pancreatic cancer patients undergoing pancreaticoduodenectomy were retrospectively analyzed, including PD + IPHP (n = 28) and PD group (n=29). IPHP was performed during surgery, on postoperative day (POD) 2, and POD 4 with normal saline as the perfusion solution. Complications and overall survival of the patients were obrved and recorded.
Results：There was no significant difference in the incidence of major postoperative complications between PD + IPHP and PD groups. The median overall survival (OS) time of the PD + IPHP group was 19.0 months, the 1-year survival rate was 82.35%, and the 2-year survival rate was 49.41%. The median OS time of the PD group was 13.0 months, the 1-year survival rate was 51.00%, and the 2-year survival rate was 27.33% (Log-rank, P = 0.030; Breslow, P = 0.039). Cox proportional risk model showed that IPHP was an independent factor to improve survival outcomes of the patients (P = 0.038; HR = 0.363, 95% CI: 0.14 - 0.94).
Conclusion：
IPHP can significantly prolong the OS of patients with pancreatic head cancer receiving radical surgery and does not increa the incidence of anastomotic leakage and other complications.
Keywords: Pancreatoduodenectomy, Pancreatic cancer, Intraperitoneal hyperthermic perfusion
英文缩写
英文缩写英文全称中文全称
PD pancreaticoduodenectomy 胰十二指肠切除术 IPHP intraperitoneal hyperthermic perfusion 腹腔
热灌注
LPD laparoscopic
pancreatoduodenectomy 腹腔镜胰十二指肠切
除术
飞翔的鹰BMI body mass index 体重指数
invasion 神经侵犯
PNI perineural
AJCC American Joint Committee on Cancer 美国癌症联合会SMV superior menteric vein 肠系膜上静脉
渡江战役纪念馆
PV portal vein门静脉
PO postoperative术后住院时间
电脑掉线ALT alanine aminotransfera谷丙转氨酶
天文
AST aspartate aminotransfera谷草转氨酶
ALP alkaline phosphata碱性磷酸酶
ALB albumin白蛋白
TB total bilirubin总胆红素
DB direct bilirubin直接胆红素
