目的

探讨低位直肠癌冷冻治疗的可行性、安全性以及有效性。

方法

回顾分析2018年1 月～2024 年5 月于湖南省中医药研究院附属医院因各种原因不适合根治性手术或放化疗而接受冷冻治疗的85 例低位直肠癌患者的临床资料，评估其在不同病理分期中的疗效，症状缓解情况及并发症等。

结果

冷冻治疗在改善患者症状上效果显著，85 例纳入研究的患者中80 例出现不同程度的症状，冷冻治疗后68 例患者症状达到缓解。不同分期的直肠癌需要冷冻治疗的次数不同，T1～2 期经过1～2次冷冻治疗能达到局部完全缓解，T3～4期的大部分需要3～4次冷冻治疗才能达到临床完全缓解的程度，甚至少量肿瘤经过4 次冷冻治疗还不能完全缓解。并发症方面，85 例患者治疗后出现9 例出血、5 例感染，其中1 例出现肛周脓肿，70 例患者出现不同程度的水肿，除了肛周脓肿行切开引流治疗，余并发症经对症保守治疗均缓解。

结论

低位直肠癌的冷冻治疗安全可行，短期内可以明显缓解直肠癌引起的症状，提高生活质量，可以作为不适合根治性手术的低位直肠癌的又一治疗选择。

Objective

To investigate the feasibility， safety， and efficacy of cryotherapy for low rectal cancer.

Methods

A retrospective analysis was conducted on the clinical data of 85 patients with low rectal cancer who underwent cryotherapy at the Affiliated Hospital of Hunan Provincial Research Institute of Traditional Chinese Medicine from January 2018 to May 2024.These patients were not suitable for radical surgery or radiotherapy and chemotherapy due to various reasons.The objective was to evaluate the efficacy， symptom relief status， and complications of cryotherapy in different pathological stages.

Results

Cryotherapy has achieved remarkable effects in improving patients’ symptoms.Among the 85 patients included in the study， eighty presented with varying degrees of symptoms， and 68 of them experienced symptom relief after cryotherapy.The number of cryotherapy sessions required varied with the stage of rectal cancer.T1～2 stages typically required 1～2 sessions for complete local remission， while T3～4 stages mostly required 3～4 sessions to achieve clinical complete remission.A small number of tumors even did not achieve complete remission after 4 sessions.In terms of complications， among the 85 cases of cryotherapy for low rectal cancer， nine cases experienced bleeding， five cases had infections （including 1 case of perianal abscess）， and 70 cases developed varying degrees of edema.Except for the perianal abscess， which required incision and drainage， all other complications were relieved with symptomatic conservative treatment.

Conclusion

Cryotherapy for low rectal cancer is safe and reliable.It can significantly alleviate symptoms caused by rectal cancer and improve quality of life in the short term， representing another viable treatment option besides conventional treatment methods for low rectal cancer that is not suitable for radical surgery.