骨盆区域复发骨与软组织肿瘤手术加术中放疗的围手术期安全性评价

发布时间：2018-09-18 09:21

【摘要】：目的探讨骨盆复发骨与软组织肿瘤手术联合术中放疗(intra-operative radiation therapy,IORT)的安全性。方法随机选取在郑州大学附属肿瘤医院住院的骨盆复发骨与软组织肿瘤患者40例,将其分为两组:手术联合IORT组(n=20),行骨盆肿瘤手术联合IORT;术前放疗联合手术组(n=20),术前常规放疗后行肿瘤扩大切除手术。比较两组患者术中、术后指标及并发症发生情况等。结果手术联合IORT组20例患者中发生术后直肠、膀胱并发症1例,明显少于术前放疗联合手术组(6例),差异有统计学意义(P0.05);手术联合IORT组患者术中出血量为(946.33±66.27)ml,略多于术前放疗联合手术组患者(750.66±56.19)ml;但手术联合IORT组患者住院时间和切口拆线时间分别为(8.27±0.64)d和(13.53±0.65)d,明显短于对照组(10.67±1.15)d和(16.17±0.76)d,差异均具有统计学意义(P0.05)。手术时间、术后血液白细胞计数、术后创腔引流量、切口液化及口感染,两组比较,差异无统计学意义(P0.05)。结论骨盆复发性骨与软组织肿瘤手术联合IORT具有术后易恢复、安全性好、常规放疗相关并发症少等优点,在临床应用中是安全可行的。
[Abstract]:Objective to evaluate the safety of intraoperative radiotherapy (intra-operative radiation therapy,IORT) combined with surgery for pelvic recurrent bone and soft tissue tumors. Methods Forty patients with pelvic recurrent bone and soft tissue tumors were randomly selected from affiliated Cancer Hospital of Zhengzhou University. They were divided into two groups: operation combined with IORT group (N20), pelvic tumor operation combined with IORT; preoperative radiotherapy combined with surgery group (N20). The postoperative indexes and complications were compared between the two groups. Results the postoperative rectum and bladder complications occurred in 20 patients in IORT group. The amount of intraoperative bleeding in the IORT group was (946.33 卤66.27) ml, slightly higher than that in the preoperative radiotherapy combined with surgery group (750.66 卤56.19) ml;, but the hospitalization time and resection time in the IORT group were significantly lower than that in the preoperative radiotherapy combined operation group (P 0.05), and the intraoperative bleeding volume in the operation combined with IORT group was (946.33 卤66.27) ml,. The time of disassembly was (8.27 卤0.64) d and (13.53 卤0.65) days, which was significantly shorter than that of the control group (10.67 卤1.15) d and (16.17 卤0.76) d, respectively. The difference was statistically significant (P0.05). There was no significant difference between the two groups in the operation time the blood leukocyte count postoperative wound drainage volume incision liquefaction and oral infection (P0.05). Conclusion pelvic recurrent bone and soft tissue tumor combined with IORT has the advantages of easy recovery, good safety and less complications associated with conventional radiotherapy. It is safe and feasible in clinical application.
【作者单位】：郑州大学附属肿瘤医院河南省肿瘤医院骨与软组织肿瘤科;郑州大学附属肿瘤医院河南省肿瘤医院放疗科;
【基金】：河南省卫生厅科技攻关项目(201403212) 河南省肿瘤医院科技拔尖人才计划支持项目(2014)
【分类号】：R738

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