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脑胶质瘤病人化疗行颈总动脉穿刺方法的探讨 |
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张永琴 李安民 张红英 张美霞
摘要 为探讨方便、可靠的化疗穿刺法，提高化疗的安全性，分别用普通动脉穿刺法和留置针穿刺法对10例脑胶质瘤病人行经颈总动脉化疗40次。结果表明：两种方法在首次穿刺成功率上经统计学处理，χ2=0.513, P>0.05，无显著性差异。说明应用留置针穿刺法化疗不降低首次穿刺成功率。但在重复穿刺率及外漏率上经统计学处理，χ2=9.453、6.805, 均 P<0.01，差异有非常显著性。提示：应用留置针法对保护颈总动脉及周围组织，降低重复穿刺及外漏率，减轻病人化疗时的痛苦，提高化疗效果有重要作用。
关键词 脑胶质瘤；动脉穿刺；化疗；留置针
Investigation on Chemotherapy with Common Carotid Artery Puncture in Brain Glioma Patients
Zhang Yongqing, Li Anmin, Zhang Hongying, Zhang Meixia
Department of Neurological Surgery, Xijing Hospital, The Fourth Military Medical
University, Xian 710032
Abstract To investigate the simple and reliable puncture chemotherapy and enhance the safety of chemotherapy, chemotherapy via common carotid artery was performed on 10 patients with brain glioma for 40 times by using general artery puncture and retaining needle puncture respectively. The reselts demonstrated that there was no statistical difference in the first puncture successful rate between the two punctures (χ2=0.513, P>0.05), suggesting that retaining needle puncture chemotherapy could not reduce the first puncture successful rate. However, there were statistical differences in repeat puncture rate and leakage rate (χ2=9.453,6.805, respectively, P<0.01). It was demonstrated that retaining needle puncture could prevent common carotid artery and its surrounding tissue, reduce repeat puncture rate and leakage rate, alleviate the pain of the patients during chemotherapy and increase the chemotherapeutic effects.
Key words brain glioma; artery puncture; chemotherapy; retaining needle
经颈总动脉穿刺化疗是治疗恶性脑胶质瘤的主要手段之一，它较超选择性颈总动脉化疗具有方便、费用低、易操作之优点；较常规静脉化疗具有全身毒副作用小、化疗效果佳等优点［1，2］。但是，经颈总动脉化疗过程中，穿刺针刺破颈总动脉造成药物外漏是常见且较严重的并发症。为探讨穿刺可靠、能有效地减少药物外漏的静脉给药方法，我们尝试将静脉留置针应用于颈总动脉穿刺行脑胶质瘤化疗，取得良好效果。报告如下。
1 临床资料与方法
1.1 临床资料 1998年5～8月在我科住院经手术治疗后病理切片证实为脑胶质瘤Ⅱ～Ⅲ级的10例病人，男9例，女1例，年龄22～57岁。术后病人神志清楚，无偏瘫、失语，行2～3个疗程的药物[1] [2] 下一页
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