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目的观察对晚期食管癌所致食管管腔梗阻患者采用内镜下缓释5-氟尿嘧啶粒子植入治疗的效果及其安全性。方法选取2012年8月至2014年10月收治的78例晚期食管癌患者,依据随机数字表法分为研究组(n=39)和对照组(n=39)。给予对照组患者常规化疗治疗,给予研究组患者内镜下缓释5-氟尿嘧啶离子植入治疗。结果治疗前两组患者吞咽困难Stooler分级均为Ⅱ、Ⅲ级,且以Ⅲ级为主;治疗后7 d对患者吞咽困难Stooler分级的评定显示:研究组患者大部分改善为Ⅰ级(71.8%),对照组Ⅰ级仅为38.5%,研究组改善程度优于对照组(P<0.05)。术后4周内镜复查疗效评估显示:研究组的总有效率、疾病控制率分别为53.8%、94.9%均显著高于对照组的30.8%、56.4%(P<0.05,P<0.01);研究组和对照组不良反应发生率为30.8%、25.6%,差异无统计学意义(P>0.05)。结论内镜下缓释5-氟尿嘧啶粒子植入治疗晚期食管癌所致食管管腔梗阻能够有效提升肿瘤局部控制率,操作简便快捷,毒副作用较小及安全性较高,效果显著。
Objective To observe the effect and safety of endoscopic delivery of 5-fluorouracil in patients with esophageal obstruction caused by advanced esophageal cancer. Methods Seventy-eight patients with advanced esophageal cancer who were admitted from August 2012 to October 2014 were divided into study group (n = 39) and control group (n = 39) according to random number table. The patients in the control group were given conventional chemotherapy, and the study group was given endoscopic fluorouracil 5-fluorouracil iontophoresis. Results Before treatment, the Stooler grading of patients with dysphagia were grade Ⅱ and Ⅲ, and grade Ⅲ was the main treatment group. Stooler grading of dysphagia patients on the 7th day after treatment showed that most of the patients in the study group were grade Ⅰ (71.8% ), Only 38.5% in control group Ⅰ, the improvement in study group was better than that in control group (P <0.05). The results of endoscopic evaluation 4 weeks after operation showed that the total effective rate and disease control rate of the study group were 53.8% and 94.9% respectively, significantly higher than that of the control group (30.8%, 56.4%, P <0.05, P <0.01). The incidence of adverse reactions in the study group and control group was 30.8% and 25.6%, respectively, with no significant difference (P> 0.05). Conclusion Endoscopic delivery of 5-Fluorouracil in the treatment of advanced esophageal cancer esophageal obstruction can effectively improve the tumor local control rate, simple and quick operation, less side effects and higher safety, the effect is significant.