华蟾素微球联合顺铂及阿霉素经肝动脉化学栓塞治疗肝癌的效果及预后

目的:探讨选用华蟾素微球联合顺铂以及阿霉素经肝动脉化学栓塞对肝癌患者进行治疗的效果及预后.方法:选取2018年10月—2019年10月本院收治的60例肝癌患者,按随机数字表分为两组,给予对照组(30例)患者顺铂联合阿霉素经肝动脉化学栓塞治疗,给予观察组(30例)患者华蟾素微球+顺铂+阿霉素经肝动脉化学栓塞治疗,观察患者...     

顺铂可降解淀粉微球兔胃动脉栓塞的实验研究

目的 选择一种新型的可降解的末梢血管栓塞剂用于进展期胃癌的介入治疗。方法 ２０例正常日本大耳白兔,分为胃动脉内化疗灌注（ｇａｓｔｒｉｃ ａｒｔｅｒｉａｌ ｉｎｆｕｓｉｏｎ,ＧＡＩ）与栓塞化疗（ｇａｓｔｒｉｅ ａｒｔｅｒｉａｌ ｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ,ＧＡＥ）两组,ＧＡＩ红顺铂（１ｍｇ／ｋｇ）用生理盐水１０ｍｌ稀释为１：１注射液胃左动脉灌注：ＧＡＥ组可降解微球（ｄｅｇｒａｄａｂｌｅ ｓｔ     

肝动脉栓塞术后二期肝切除治疗原发性肝癌的体会

作者报道了１９６例巨块型肝癌经肝动脉栓塞术后，２０例获得二期切除，术后１、２、３、５年生存率分别为８５％、７０％、６０％、２５％。作者对ＨＡＥ的重要性进行了讨论，并指出二期肝切除的适应证及必要性。强调当ＨＡＥ使肿瘤缩小，病变转为可能切除时，应不失时机地施行二期肝切除术。     

原发性肝癌经肝动脉栓塞化疗术后再行肝切除的临床观察

１９８７年１月至１９９２年１２月，作者共为４８例经肝动脉栓塞化疗（ＨＡＣＥ）后肿瘤缩小的肝癌患者施行了肝切除术。全组无手术死亡。术后１、２、３年生存率分别为８４．６％、５７．２％和４４．９％。已有２例生存时间超过５年。本文对原发性肝癌（ＰＨＣ）经ＨＡＣＥ后再行切除的临床意义以及ＨＡＣＥ后再作肝切除的手术时机问题进行了讨论。     

肝动脉栓塞化疗后肝内胆道并发症（附108例分析）

目的 探讨肝动脉栓塞化疗引起肝脏胆道并发症的临床表现,病理改变,发病机理及预防治疗的方法。方法 观察１９９０年６月至１９９９年６月收治１０８例经过１～６次肝动态栓塞化疗患者治疗结果。结果 肝动脉栓塞化疗４次以上得３５例,发现胆道病变６例,发生率为１７．１４％;化疗３次以下者７３例,发生２例,为２．４７％,显著低于前者。结论 发生机理可能主要是因为胆管的营养血管多次被栓塞而没有及时建立起有效的侧支循     

肝动脉栓塞化疗后肝切除治疗中晚期肝癌

目前原发性肝癌首选的治疗方法仍然是肿瘤切除。临床上常遇到的病人大部分为中晚期肝癌,癌肿体积大,常侵犯或紧靠第一、二肝门及下腔静脉,多合并肝硬化,而不能手术切除。对这部分病人进行肝动脉栓塞化疗,被认为是一种有效的姑息治疗方法之一,可延长病人寿命。另外,部分病人栓塞化疗肿瘤缩小后再行肝切除术,以达到根治性治疗的效果。我院1991年5月以来行肝动脉栓塞化疗500多例,其中行肝切除43例,现就其治疗情况分析讨论。临床资料1　一般资料:本组43例,男39例,女4例,年龄29～67岁,平均50.4岁。合并肝硬化39例,乙肝表面抗原阳性者37例。全部病…     

肝癌肝动脉栓塞化疗后磁共振成像检查特征

Hepatocelular carcinoma ( HCC) is one of the most common causes of cancer death worldwide. Although surgical resection offers a better curative option than nonsurgical treatments, it is not an option for the majority of patients with poor hepatic function or at an advanced stage when diagnosed.Transcatheter arterial chemoembolization (TACE) is an alternative and effective nonsurgical treatment for HCC. Evaluation of the effect of TACE is important to develop a best therapeutic strategy. From January 2009 to December 2010, 28 patients with HCC received TACE at the PLA General Hospital, and the results of magnetic resonance imaging ( MRI) were analyzed. Fifty-one lesions were detected and the maximum diameter of the lesions was 14.7 cm. Twenty-eight lesions in 16 patients which showed variable signal intensity on T1- and T2 -weighted images and iso- or hypointensity on diffusion-weighted image ( DWI) had no enhancement. Five lesions of 10 tumors in four patients had focal enhancement in the first MRI after TACE that displayed hyperintensity on DWI. Eight patients had been found with tumor recurrence or metastasis when they received MRI for the second time. The recurrent, residual and intrahepatic metastatic tumors enhanced rapidly at dynamic early phase scanning and demonstrated hyperintensity on T2 -weighted images.     

兔肝癌肝动脉栓塞后肿瘤血管生成的变化

目的　观察肝癌肝动脉栓塞后肿瘤组织血管生成的变化。方法　建立兔肝癌模型 ,随机分栓塞组 (n =10 )和对照组 (n =10 )。于接种后 14d经肝动脉注入超液化碘油 (栓塞组 )或等量生理盐水 (对照组 )。栓塞后第 7天取肿瘤 ,免疫组织化学方法检测肿瘤组织微血管密度 (MVD)及血管内皮生长因子 (VEGF)蛋白的表达 ,逆转录 聚合酶链反应 (RT PCR)检测VEGFmRNA的表达。结果　栓塞组MVD (2 8.6± 10 .6)与对照组 (16.3± 6.9)比较差异有非常显著性 (t =3 .0 83 ,P <0 .0 1) ;栓塞后VEGF蛋白 (t =3 .0 75 ,P <0 .0 1)及VEGF165mRNA (t =3 .95 4,P <0 .0 0 1)表达水平显著增高 ;在栓塞组和对照组 ,VEGF蛋白表达均与MVD呈正相关 (r分别为 0 .69和 0 .72 ,P <0 .0 5 )。结论　肝动脉栓塞术可通过促使肿瘤细胞VEGF表达上调 ,从而促进肿瘤的血管生成 ,如果将介入栓塞与抗血管生成治疗相结合 ,可望提高栓塞治疗效果     

肝动脉栓塞术后二期肝切除治疗原发性肝癌的体会

作者报道１９６例巨块型肝癌经肝动脉栓塞术（ＨＡＥ）后，２０例获得二期切除（１０．２０％）。术后１、２、３、５年生存率分别为８５％、７０％、６０％、２５％。作者对ＨＡＥ的重要性进行了讨论，并指出二期肝切除的适应证及必要性。强调当ＨＡＥ使肿瘤缩小，病变转为可能切除时，应不失时机地施行二期肝切除术。     

顺铂联合加热对体外血液中肝肿瘤细胞的杀灭作用及对红细胞的影响

目的 探讨顺铂(DDP)联合加热对体外血液中肝肿瘤细胞的杀灭作用及对红细胞的影响.方法 将肝肿瘤细胞2 ml加入10 ml红细胞悬液中,充分混匀后,分别取2 ml于离心管中.采用随机数字表法,将其随机分为6组(n=30):A组、D组各加入2 ml生理盐水,B组、E组各加入2 mlDDP(终浓度为100 μg/ml),C组和F组各加入2 ml DDP(终浓度为200 μg/ml).充分混匀后,A组、B组和C组放入37℃恒温水浴箱中,其余3组放入42℃恒温水浴箱中进行加热处理,处理时间均为30min.采用密度梯度离心法分离肝肿瘤细胞和红细胞,测定肝肿瘤细胞抑制率及克隆形成率,测定红细胞渗透脆性及2,3-二磷酸甘油酸(2,3-DPG)含量.结果 随温度和DDP浓度的升高,肿瘤细胞的抑制率升高,克隆形成率降低(P<0.01).F组肿瘤细胞抑制率达98%以上,且未出现克隆形成.处理前后F组红细胞2,3-DPG含量比较差异无统计学意义(P->0.05).处理后F组红细胞在0.68%NaCl溶液中的溶血率<1%.结论 200 μg/ml DDP联合42 ℃加热30 min,可使体外血液中肝肿瘤细胞失去增殖能力,而对红细胞膜的影响轻微,对红细胞的携氧能力无影响.

Abstract：

Objective To investigate the effectiveness of cis-diamminedichloroplatinum (DDP) combined with hyperthennia in killing liver tumor cells and its influence on erythrocytes in vitro. Methods Cultured liver tumor cells (2 ml) were mixed with erythrocyte suspension (10 ml) and then the mixture was separated into 6 centrifuge tubes with 2 ml in each one. The centrifuge tubes were randomly divided into A-F groups and the experiment was repeated for 30 times. Normal saline 2 ml was added in A and D groups. DDP 2 ml (200 μg/ml) was added in B and E groups. DDP 2 ml (400 μg/ml) was added in C and F groups. The cells were then incubated in warm bath of 37 ℃ for 30 min in A, B and C groups and in warm bath of 42 ℃ for 30 min in the other three groups.After hyperthermic treatment, tumor cells were isolated from erythrocytes using density gradient centrifugation, the inhibition rate of tumor cells was determined by MTT method and the clone formation of tumor cells was checked.The erythrocyte osmotic fragility and content of 2,3-diphosphoglyceric acid in erythrocytes were measured. Results The inhibition rate of tumor cells was gradually increased, while the rate of tumor cell clone formation decreased with the increase in the temperature and DDP concentrations ( P < 0.01) . The rate of tumor cell clone formation was more than 98% and no clone formation was tested in group F. There was no significant difference in the content of 2,3-diphosphoglyceric acid in erythrocytes between before and after hyperthermic treatment in group F ( P >0.05 ) . The rate of hemolysis of erythrocytes was less than 1 % in the 0.68 % sodium chloride solution in group F.Conclusion DDP 200 μg/ml combined with hyperthermic treatment with temperature of 42 ℃ for 30 min can make the liver tumor cells lose the capability of proliferation, however, it exerts slight effect on erythrocyte membrane and no influence on the oxygen-carrying capacity of erythrocytes.     

射频联合肝动脉栓塞化疗及无水酒精注射治疗不能手术切除的肝癌

目的：探讨射频固化（RFA）联合肝动脉化疗栓塞（TACE）及无水酒精注射（PEI）治疗不能手术切除的肝癌的效果。方法：对41例肝癌应用RFA联合TACE及PEI治疗的临床资料进行回顾性分析。结果：原发性肝癌（PHT）30例，转移性肝癌（MPT）11例。治疗后影像学显示病灶好转或稳定26例。PHT30例中治疗前甲胎蛋白阳性16例，术后降至正常12例。未发生严重并发症。结论：RFA联合TACE及PEI系一安全、可耐受，有效的新的综合治疗方法。可提高不能切除的肝癌的治疗效果。     

肝动脉栓塞术后的肝内外胆道损毁性病变

目的 探讨经导管肝动态栓塞术后对胆道损伤的病因、治疗及预防。方法 总结５例因肝动脉栓塞引起的胆道损伤患者,其中４例为肝血管瘤经导管动脉栓塞术后,１例为手术时结扎肝动脉注射ＴＨ胶后。动物实验观察向大鼠肝动脉内注射乙醇复制血管栓塞剂对肝脏的损伤。结果 ５例患者均有胆道毁坏性病变,甚至造成胆汁性肝硬化,４例进行胆管空肠吻合及胆道支撑。实验结果证实肝动脉注射血管硬化剂无水乙醇后可以引起邻近汇管区肝脏局部坏