支气管动脉化疗灌注对存在肝动静脉瘘的肝癌肺转移的预防

目的:探讨支气管动脉化疗灌注对存在肝动脉肝静脉瘘的肝癌肺转移的预防作用。方法:对28例存在肝动脉肝静脉瘘的肝癌患者,13例单纯行肝癌的介入治疗(对照组);15例行肝癌的介入治疗联合支气管动脉化疗灌注(BAI)(治疗组)。随访记录两组患者的肺转移与生存情况。结果:两组病例随访3~12个月。对照组发生肺转移9例,3、6和12个月肺转移率分别为55.6%、100%和100%,其生存率分别为69.2%、30.8%和7.70%。治疗组仅见2例肺转移,其3、6和12个月肺转移率分别为0、7.70%和14.3%,生存率分别为93.3%、86.7%和46.7%。两组肺转移率及生存率对比有明显差异。结论:对存在肝动脉肝静脉瘘的肝癌行预防性支气管动脉化疗灌注可以有效预防肺转移,提高病人生存率。

Combined transarterial chemoembolization and bronchial artery infusion to prevent lung metastases from liver cancer with hepatic artery hepatic veaous fistula

Objective:To study the value for prevention in metastases of lung from liver cancer with hepatic artery hepatic venous fistula (HAHVF) by bronchial artery infusion(BAI).Methods: Twenty eight cases of liver cancer with HAHVF were divided into two groups. In control group, 13 cases were treated only by transarterial chemoembolization(TACE). In therapeutic group, Combined treatment of 15 cases with TACE and BAI was given to prevent metastases of lung from liver cancer with HAHVF. The cases were followed up from 3 to 12 monthes. The lung metastatic rate and the survival rate of the patients were recorded in two groups. Results: In control group , the lung metastasis were found in 9 of 13 cases, 3, 6, 12 month metastatic rates were 55.6%,100%,100% respectively and the survival rates were 69.2%,30.8%,7.70% respectively. In therapeutic group , the metastases were found in 2 of 15 patients,3, 6, 12 month metastatic rates were 0,7.70%,14.3% respectively and the survival rates were 93.3%,86.7%,46.7% respectively. The lung metastatic rates and the survival rates between two groups were significant different. Conclusion: BAI is a very effective method for prevention of the lung metastases from liver cancer with HAHVF. Combined use of TACE and BAI is superior to TACE alone for reducing the metastatic rate of lung and increasing the survival rate for cases of liver cancer with HAHVF.