原发性巨块型肝癌经动脉大剂量碘化油栓塞的应用分析

 目的 回顾性分析原发性巨块型肝癌经动脉注射25～40 mI碘化油栓塞病例的判断治疗效果及安全性。方法 47例原发性巨块型肝癌经动脉注射25～40 mI碘化油栓塞，记录术前肿瘤最大径、肝功能、肾功能、肝硬化程度（Child分级），术中造影情况、碘化油剂量及术后随访肿瘤最大径、碘化油沉积情况、肝功能、肾功能、肝硬化程度（Child分级）和并发症。结果 本组病例术前肿瘤最大径为（13.02±10.52）cm，所有患者均为Child A。47例DSS均显示门静脉主干通畅；碘化油用量平均为27.84 mL(范围25～40 mL)。术后2周后随访肝、肾均有不同程度的损害，4周后均可恢复。术后4周复查CT测量肿瘤最大径为(5.17±0.45)cm (P=0.000 0)，肿瘤内碘化油沉积4度为85.1%。所有患者均未发生与经肝动脉栓塞化疗（TACE）有关的严重并发症。结论 原发性巨块型肝癌，经严格的术前评估，术中又将导管或微导管超选择至肿瘤供血动脉，对肿瘤进行完全的充填，术后的积极治疗可以避免严重并发症。我们认为对于首次TACE行大剂量碘油栓塞治疗原发性巨块型肝癌患者是安全的。

The utility of large dosage lipiodol treatment in huge primary hepatic carcinoma:a report of 47 cases

Objective To evaluate the effect and safety of large dosage iodized oil(lipiodol) treatment in huge primary hepatic carcinoma(PHC) via injecting from hepatic artery in each transarterial chemoembolization(TACE) case. Methods Fourty-seven cases with huge PHC received over 25 mL lipiodol injection in each TACE.Tumor maximal diameter,liver function,renal function,Child classification were recorded both before and after TACE.Angiography,lipiodol dosage and deposition in tumor and complications were also recorde...