肝转移癌灌注化疗(HAIC)简介术前准备 HAIC技术技术上的考虑 结直肠癌肝转移HAIC并发症 结直肠癌肝转移疗效 结直肠癌肝转移HAIC总结
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术前准备

时间:2021-12-31 13:54来源:www.ynjr.net 作者:杨宁介入医学网
参与此项治疗的介入医生、外科医生和肿瘤内科医生应详知HAIC(经动脉灌注化疗)方法,原理,相关并发症和病人管理。 Work-upPreoperative imaging included cross-sectional imaging with computed tomography (CT) and/or magnetic resonance imaging (MRI)
 
参与此项治疗的介入医生、外科医生和肿瘤内科医生应详知HAIC(经动脉灌注化疗)方法,原理,相关并发症和病人管理。
 
Work-upPreoperative imaging included cross-sectional imaging with computed tomography (CT) and/or magnetic resonance imaging (MRI) of the abdomen and pelvis and CT of the chest.
术前影像学包括腹部和骨盆的计算机断层扫描(CT)和/或磁共振成像(MRI)和胸部的CT。
 
Patients were evaluated with a CT angiogram for nonstandard arterial anatomy.
患者采用CT血管造影进行非标准动脉解剖评估。
 
Fluorodeoxyglucose–positron emission tomography (PET) scans and MRI were used selectively at the discretion of the treating physicians.
氟脱氧葡萄糖正电子发射断层扫描(PET)扫描和MRI由治疗医生选择性使用。
 
Hepatic intra-arterial pump insertion and treatmentPre-operatively a CT angiogram was performed to evaluate for non-standard arterial anatomy.
术前行CT血管造影,以评估非标准动脉解剖情况。
 
 Laparotomy was performed to place the pump subcutaneously in the abdominal wall.
行剖腹切除术,将泵置于腹壁皮下,或经皮动脉穿刺将泵置于皮下。
 
 The catheter tip was positioned at the origin of the gastroduodenal artery as previously described.
如前所述,导管尖端位于胃十二指肠动脉的起点【17,18】。
 
 Bilobar hepatic perfusion and lack of extrahepatic perfusion were confirmed by both intra-operative dye testing and postoperative technetium-99-labeled nuclear medicine scanning.
若开腹术中染色试验和术后锝-99标记的核药物扫描均证实了Bilobar肝灌注和肝外灌注不足。
 
 All collateral branches distal to the catheter and proximal to the liver were ligated to avoid extrahepatic perfusion.
结扎导管远端和肝脏近端的所有侧支分支,以避免肝外灌注【17,18】。

Patients with extrahepatic perfusion were evaluated angiographically and aberrant branches were embolized before initiation of treatment.
有肝外灌注的患者进行血管造影评估,并在开始治疗前栓塞异常分支。
 
 
The HAIP was filled with heparinized saline solution approximately every 2 weeks until the start of HAIP chemotherapy to prevent thrombosis of the catheter.
HAIP大约每2周填充一次肝素化生理盐水,直到HAIP化疗开始,以防止导管血栓形成。
 
 Patients were evaluated every 2 weeks when the pump was filled.
当充满泵后,每2周对患者进行一次评估。
 
 FUDR was administered based on the MSKCC regimen (0.FUDR是基于MSKCC方案(0.12 mg/kg/day) as previously described every 4 weeks with heparin saline refills every 2 weeks between cycles.
12mg/kg/天),每个周期之间每2周补充一次肝素生理盐水【19, 20】。
 
 Patients were evaluated in the clinic when the pump was refilled and their liver function tests (LFTs) were reviewed while on treatment.
患者在重新填充泵时进行临床评估,并在治疗期间复查他们的肝功能测试(LFTs)。
 
 FUDR dose modifications were made following previously established algorithms that use liver function tests and bilirubin to guide dose reductions and holding treatment.
FUDR剂量的修改是根据先前建立的算法,使用肝功能测试和胆红素来指导剂量减少和保持治疗【21】。
 
Dexamethasone was added to FUDR infusion when patients demonstrated any concerns for biliary toxicity.
当患者出现胆道毒性问题时,在FUDR输注中加入地塞米松【22】。
 
Patients who did not complete HAIP treatment due to toxicity or pump failure were included in this database.
因毒性或泵失效而未完成HAIP治疗的患者被纳入该数据库。
 
Systemic chemotherapy before HAIP chemotherapy and during HAIP was provided to patients and was determined by the treating medical oncologist following the regional guidelines based on patients’ comorbidities, past chemotherapy, and disease burden.
在HAIP化疗前和HAIP期间向患者提供全身化疗,由治疗肿瘤医生根据基于患者共病、既往化疗和疾病负担的区域指南确定。
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