p53腺病毒注射液联合榄香烯、氟尿嘧啶门静脉灌注预防小肝癌术后复发的研究

目的探讨经门静脉途径联合应用p53腺病毒注射液（p53）、榄香烯、氟尿嘧啶（5-Fu）预防小肝癌术后复发的作用。方法男性小肝癌患者5例，于B超和电视透视联合引导下穿刺门静脉，留置4F导管，用重组人p53腺病毒注射液、榄香烯联合5-Fu门静脉滴注，每天1次共5d。第5天药物滴注完毕后在电视透视下拔出导管，用TH胶填塞肝脏穿刺通道。结果5例患者均完成了治疗计划。门静脉穿刺插管及拔管，药物灌注操作顺利，未出现门静脉血栓形成，穿刺通道出血，导管移位等并发症。p53门静脉滴注后主要副反应为发热达39～40℃，持续1—3h，物理降温加药物退热有效。榄香烯联合5-Fu门静脉滴注药物副反应轻微。5例患者随访5～16个月（平均8．5个月），其间影像学及血液学检查未显示新发肝癌病灶或原发肝癌病灶复发。结论介入性门静脉穿刺插管门静脉途径p53腺病毒注射液、榄香烯、5-Fu联合应用可能对小肝癌术后复发起到抑制和治疗作用。

Effect of p53 combined with elemene and 5-Fu via portal vein for preventing recurrence of small liver cancer

Objective To evaluate the effects of p53 combined with elenlene and 5-Fu infusion via portal vein for preventing recurrence of small liver cancer after operation.Methods Five male patients with small fiver cancer which have been performed operation(2 cases)or combine interventional procedures(3 cases).A 4F catheter was inserted into portal vein under guiding by B type ultrasound and fluoroscopy.The drugs infused into portal vein in-cluded recombinant human Ad-p53 injection,elemene emulsion,and 5Fu.After finished the drugs infusion plan,the catheter was removed and puncturing duct of the live was occluded by TH glue.Results Five patients received the treatment according to treating plan.Portal vein catheter insertion and remove was finished smoothly.No complications such as portal vein thrombosis,bleeding of live puncturing duct,catheters abnormal location were found.Side effects of p53 gone was fever as 39～40℃ or 1 to 3 hours.Elemene and 5-Fu injection has micro side effects.Five patients were followed up for 5 t0 16 months(average 8.5 months).There were no tumor recurrence evidence provided by radi-ology and hemotology during following time.Conclusion Primary results suggest that p53 infusion via portal vein may inhibit and treat fiver camcer recurrence.Control stndy and long time following is needed.