共查询到19条相似文献,搜索用时 93 毫秒
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目的:研究中晚期肝细胞性肝癌切除术前应用肝动脉化疗栓塞治疗是否能够降低术后复发及提高患者生存率。方法:100例术前辅以介入治疗(介入组),另外100例作为同期对照组(未介入组),比较两组的累计生存率和无瘤生存率。结果:介入组和未介入组1、2年无瘤生存率比较差异有统计学意义(P〈0.05);介入组1、2年生存率(83%、62%)亦高于未介入组(47%、33%),两组术后累计生存率比较差异有统计学意义(P〈0.05)。介入组患者均未出现与介入治疗相关的肝、肾毒性或影响手术的不良反应。结论:中晚期肝细胞性肝癌术前辅以肝动脉化疗栓塞治疗可显著提高术后生存率,减少复发。 相似文献
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中晚期肝癌肝动脉灌注化疗栓塞的临床分析 总被引:4,自引:0,他引:4
目的总结中晚期肝癌肝动脉灌注化疗栓塞术后情况及疗效.方法采用seldinger技术,经皮股动脉插管进行肝动脉灌注化疗药物加栓塞剂.结果治疗后1~4周AFP降低超过原来数值20%的占69%.术后1个月肝区平片或第二次介入治疗前行肝动脉造影可见肿瘤均有不同程度缩小.本组病人治疗后1、2、3年生存期分别为38.2%、4.1%、2.4%.治疗后出现上消化道出血18例,15例治愈,3例死亡.结论肝动脉灌注化疗栓塞治疗中期晚期肝癌是一种姑息疗法,对于减轻症状,延长寿命效果好.但术中及术后会产生一些反应,甚至严重的并发症,危及病人生命,应引起注意. 相似文献
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肝动脉化疗加栓塞治疗肝癌的观察与护理 总被引:3,自引:0,他引:3
目的 通过对介入治疗原发性肝癌的术前、术后的观察和护理,探讨确保顺利进行治疗的一整套护理方法。方法 对105例原发性肝癌实施介入治疗,采取seldinger技术局麻下股动脉穿刺,导管超选择肝动脉灌注化疗药物和栓塞剂。从护理角度上去完善检查,术前加强心理护理、饮食指导,术后在做好常规护理的情况下,重点从毒副反应(如疼痛、发热、消化道反应、血液系统抑制等)和并发症等方面进行详细观察和处理。结果 由于措施得当,处理及时,本组未发生一例并发症,并积极防止了因白细胞减少引起的感染发热和消化道反应引起的体重下降。结论 做好原发性肝癌介入治疗前、后的护理工作,是确保病人治疗顺利进行的重要条件,亦是提高治疗效果必不可少的措施。 相似文献
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经肝动脉门静脉选择性化疗栓塞治疗中晚期肝癌 总被引:1,自引:1,他引:1
自1993年10月~1995年4月采用经肝动脉门静脉置入化疗泵,行选择性化疗栓塞治疗中晚期肝癌28例,报告如下。1材料与方法本组男性25例,女性3例,年龄28~69岁,平均40.2岁。单纯型Ⅱ期4例,Ⅲ期3例,硬化型Ⅱ期17例,Ⅲ期4例。剖腹探查证实肝癌无法切除,取肝癌组织活检以明确其病理类型。选定拟行插管的血管(首选胃网膜右动静脉),将充满100U/ml肝素液的化疗泵导管插至肝侧,经导管注入美蓝液(2ml美蓝加8ml生理盐水),见肿瘤侧肝组织蓝染以确定导管插入的位置及灌注范围,双重结扎固定导管… 相似文献
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肝动脉化疗栓塞治疗中晚期肝癌的临床分析 总被引:7,自引:0,他引:7
目的:通过中晚期肝癌患者的肝动脉化疗栓塞(TACE)的临床观察,探讨该方法的应用价值。方法:采用seldinger技术,经皮股动脉插管进行肝动脉灌注化疗药物加栓塞剂。结果:通过对241例患者随访,治疗后4-6周复查CT、B超肿块有不同程度缩小,AFP降低至原来数值的50%以下占68%。本组患者治疗后1、2、3年生存期分别为65.3%、27.2%、10.1%。平均生存期为17.6个月。结论:肝动脉化疗栓塞(TACE)治疗中晚期肝癌是一种有效方法,虽属姑息治疗,但可减轻症状,延长生命。 相似文献
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目的 通过对介入治疗原发性肝癌的术前、术后的观察和护理,探讨确保顺利进行治疗的一整套护理方法。方法 对10 5例原发性肝癌实施介入治疗,采取Seldinger技术局麻下股动脉穿刺,导管超选择肝动脉灌注化疗药物和栓塞剂。从护理角度上去完善检查,术前加强心理护理、饮食指导,术后在做好常规护理的情况下,重点从毒副反应(如疼痛、发热、消化道反应、血液系统抑制等)和并发症等方面进行详细观察和处理。结果 由于措施得当,处理及时,本组未发生一例并发症,并积极防止了因白细胞减少引起的感染发热和消化道反应引起的体重下降。结论 做好原发性肝癌介入治疗前、后的护理工作,是确保病人治疗顺利进行的重要条件,亦是提高治疗效果必不可少的措施。 相似文献
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肝癌栓塞化疗后的远期生存率评价 总被引:16,自引:0,他引:16
陈晓明 《国外医学(肿瘤学分册)》1998,25(1):46-48
本文对肝细胞性肝癌(HCC)行经导管肝动脉栓塞化疗后的1、2、3、4、5年生存率作了综述。影响HCC栓塞化疗远期生存率的因素包括栓塞化疗方式、肿瘤大小、肿瘤类型、生长方式、门脉是否受侵、肝功能拳头及磺油沉积方式。栓塞化疗的联合经皮穿刺无水乙醇注射(PEI)可明显提高远期生存率。 相似文献
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目的:评价热化疗栓塞对原发性肝癌的中长期疗效。方法:回顾性分析1994年11月至2012年2月172例原发性肝癌行热化疗栓塞治疗患者的临床资料,应用Seldinger技术,经股动脉穿刺置管,通过肝动脉导管将微导管超选择置入肿瘤供血动脉,以碘油20ml与顺铂100mg或丝裂霉素8mg的110℃混悬液行热化疗栓塞。以门诊及电话方式随访收集资料。通过影像学检查观察肿瘤大小变化,用寿命表法计算患者累积生存率。结果:1-10年累积生存率分别为52.33%、34.88%、21.51%、12.21%、7.56%、1.74%、1.74%、1.16%、1.16%、1.16%。治疗前后有CT、B超或DSA等影像学资料对比的患者160例,完全缓解(CR) 2例(1.25%),部分缓解(PR)49例(30.63%),稳定(SD)78例(48.75%),进展(PD)31例(19.38%);有效率(CR+PR)31.88%,肿瘤控制率(CR+PR+SD)80.63%。结论:热化疗栓塞是原发性肝癌的有效治疗手段。 相似文献
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影响肝细胞癌术后长期生存的相关因素 总被引:2,自引:0,他引:2
通过对复旦大学肝癌研究所20世纪90年代手术治疗的2333例肝细胞癌病例的分析,旨在寻找与长期生存的相关因素.其中根治性切除1465(62.8%)例,姑息性切除868例(37.2%).随访至2003年底,术后存活5年以上者527例,其中根治性切除组454例,姑息性切除组73例.根治性切除后长期生存的相关因素为肿瘤的发现途径,肿瘤大小、包膜,肿瘤细胞的分化程度,肝硬化程度,血清γ-GT水平.姑息性切除后长期生存的相关因素为肿瘤大小、肿瘤包膜、γ-GT、肝硬化程度、术后TACE和二步切除是长期生存独立的影响因素.术后复发的病人经过综合治疗后也能达到比较理想的长期生存率. 相似文献
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肝细胞癌周围微小病灶的影像诊断与介入治疗 总被引:5,自引:0,他引:5
目的:探讨肝细胞癌病灶周围微小病灶的影像诊断及介入治疗效果。方法:由两名有经验的放射学医生共同回顾性分析80例肝细胞癌病灶周围微小病灶的螺旋CT及血管造影表现,并达成一致意见。所有病例均行经肝动脉化疗栓塞治疗。结果:80例肝癌患者经螺旋CT或/和DSA造影发现病灶周围微小病灶者37例,其中微小病灶只分布于主灶周围1cm范围内者21例。经肝动脉化疗栓塞治疗可栓塞肝细胞癌周围的微小病灶。结论:肝细胞癌病灶周围的微小病灶存在较为广泛,术前准确诊断有利于指导经肝动脉化疗栓塞治疗。 相似文献
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晚期肝癌低频超声空化治疗的超声血管造影表现 总被引:3,自引:0,他引:3
目的观察晚期肝癌患者低频超声空化治疗的超声血管造影表现。方法晚期肝癌患者12例(其中原发性肝癌7例,转移性肝癌5例),行低频超声空化治疗。治疗前、后进行超声微血管造影。结果通过超声血管造影能够清晰地看到肿瘤微血管。低频超声空化治疗后肿瘤血管造影强度低于治疗前,且治疗后病灶内出现低回声区。结论低频超声空化治疗具有毁损肿瘤血管的作用;超声微血管造影可以用来评估低频超声空化治疗后肿瘤血管的破坏情况。 相似文献
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目的:研究血清降钙素原与C-反应蛋白联合监测肝癌患者介入手术感染价值,为临床诊治提供参考。方法:选取我院于2011年10月至2017年10月期间收治的肝癌介入手术感染患者134例为试验组,另选同期未感染患者120例作为对照组。两组患者均采用免疫比浊法测定C-反应蛋白含量,采用电化学发光法测定降钙素原含量,对比其血清C-反应蛋白和降钙素原含量、C-反应蛋白及降钙素原阳性率、C-反应蛋白联合降钙素原诊断灵敏度和特异度。结果:试验组血清降钙素原及C-反应蛋白含量均高于对照组,差异有统计学意义(P<0.05);试验组降钙素原及C-反应蛋白阳性率均高于对照组,差异有统计学意义(P<0.05);降钙素原联合C-反应蛋白的诊断灵敏度及特异度优于单项诊断,差异有统计学意义(P<0.05)。结论:肝癌患者介入手术感染后血清降钙素原及C-反应蛋白含量升高明显,若联合降钙素原及C-反应蛋白诊断,其灵敏度及特异度更高,可为临床诊治提供重要参考。 相似文献
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D H Palmer S A Hussain A J Smith S Hargreaves Y T Ma D Hull P J Johnson P J Ross 《British journal of cancer》2013,109(4):888-890
Background:
The prognosis for hepatocellular carcinoma (HCC) is dependent upon tumour stage, performance status (PS), severity of underlying liver disease, and the availability of appropriate therapies. The unavailability of sorafenib may have a significantly adverse effect on the prognosis of UK patients with advanced HCC. During the study period, access to sorafenib was at the discretion of local health funding bodies, a process that may delay or deny access to the drug and that remains in place for Wales, Scotland, and Northern Ireland. Here, we attempt to address the impact of this system on patients with advanced HCC in the United Kingdom.Methods:
This is a retrospective study performed in the two largest specialist hepatobiliary oncology units in the United Kingdom. Funding applications were made to local funding bodies for patients with advanced HCC for whom sorafenib was considered appropriate (advanced HCC not suitable for loco-regional therapies, compensated chronic liver disease, PS 0–2).Results:
A total of 133 applications were made, of which 57 (43%) were approved and 76 (57%) declined. Demographics and prognostic factors were balanced between the two groups. This cohort had a number of adverse prognostic features: patients were predominantly PS 1–2; the majority had multifocal disease with the largest lesion being >5 cm; and macroscopic vascular invasion, metastases, and AFP >1000 ng ml−1, were each present in one-third of cases. The median time from application to funding decision was 17 days (range 3–260 days). For the primary ‘intention-to-treat'' analysis, median overall survival was 4.1 months when funding was declined, and 9.5 months when funding was approved (hazard ratio (HR) 0.48; 95% CI 0.3186–0.7267; P=0.0005).Conclusion:
These data support the use of sorafenib for patients with advanced HCC as an effective intervention. In the United Kingdom, this applies to a relatively small group of patients, estimated to total ∼800 per year who, unfortunately, do not survive long enough to themselves lobby for the availability of this drug. These data provide a comparison of sorafenib with supportive care and demonstrate the potential detrimental impact on patient outcomes of rationing health-care resources on the basis of cost. 相似文献19.
Yang Ke Liang Ma Xue-Mei You Sheng-Xin Huang Yong-Rong Liang Bang-De Xiang Le-Qun Li Jian-Hong Zhong 《临床肿瘤与癌症研究(英文版)》2013,(3):158-164
Objective: To assess the effect of antiviral therapy for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radical hepatectomy. Methods: A total of 478 HBV-related HCC patients treated by radical hepatectomy were retrospectively collected. Patients in the treatment group (n=141) received postoperative lamivudine treatment (100 rag/d), whereas patients in the control group (n=337) did not. Recurrence-free survival (RFS) rates, overall survival (OS) rates, treatments for recurrent HCC and cause of death were compared between the two groups. Propensity score matching (PSM) analysis was also conducted to reduce confounding bias between the two groups. Results: The 1-, 3-, and 5-year RFS rates didn't significantly differ between the two groups (P=0.778); however, the 1-, 3-, and 5-year OS rates in the treatment group were significantly higher than those in the control group (P=0.002). Similar results were observed in the matched data. Subgroup analysis showed that antiviral treatment conferred a significant survival benefit for Barcelona Clinical Liver Cancer stage A/B patients. Following HCC recurrence, more people in the treatment group were able to choose curative treatments than those in the control group (P=0.031). For cause of death, fewer people in the treatment group died of liver failure than those in the control group (P=0.041). Conclusion: Postoperative antiviral therapy increases chances of receiving curative treatments for recurrent HCC and prevents death because of liver failure, thereby significantly prolonging OS, especially in early- or intermedian-stage tumors. 相似文献