经皮左锁骨下动脉埋置药盒治疗肝转移性肿瘤

目的 评价经皮左锁骨下动脉穿刺导管药盒系统植入术治疗肝转移性肿瘤的作用。方法 22例肝转移性肿瘤,其中来源于胃肠道转移的14例,来源于其它脏器转移8例。行经皮左锁骨下动脉穿刺导管药盒系统植入术。术后经导管药盒系统灌注化疗药物。结果 导管药盒系统植入术技术成功率100％。生存期：6个月生存率79%,1年生存率58％,2年生存率30.4%,3年生存率17%。术后1－3个月CT复查,肿瘤体积缩小 大于50％者占27.27％,无变化者占36.36%,增大者占9.1%。手术并发症有;少量气胸1例,左锁骨下区药盒附近感染,拔除导管药盒1例,导管移位至右肾动脉经再次插管调整导管于靶动脉1例。结论 经皮导管药盒系统植入术适用于肝转移瘤的长期动脉内灌注化疗,疗效满意,并发症少,值得推广应用。

Percutaneous subclavian artery port-catheter system implantation for treatment of liver metastases

Objective To evaluate the efficacy of port-catheter system (PCS) implantation in the treatment of liver metastases. Methods Percutaneous puncture of subclavian artery and PCS implantation were carried out in 22 patients with liver metastases from gastrointestinal cancers (n = 14) and cancers of other organs (n = 8). All patients were treated with intraarterial chemotherapy monthly. Results The rate of success was 100 %. The 0.5～, 1～, 2-～and 3-year survival rate were 79%, 58%, 30.4% and 17% respectively. Tumor shrinkage more than 50% in diameter was detected in 27.27 % by CT, and that less than 50 % also 27.27 %. No change was found in 36.36 % while enlargement of tumor was present in 9.1%. The complications related to the technique included pneumothorax ( n = 1 ) and regional infection( n = 1 ). but all were cured with no sequela. After PCS implantation, Catheter migvation in one case was reinserted to the target artery. Conclusion Percutaneous PCS implatation is effective for long-term intraarterial chemotherapy in treatmemt of liver metastases. (Shanghai Med J, 2001,24:143)