大剂量超液态碘油栓塞治疗巨块富血管型肝癌

目的:探讨大剂量碘油栓塞治疗巨块型富血管肝癌的疗效。方法:使用Seldinger穿刺方法,经股动脉置管行肝动脉栓塞化疗治疗巨块型富血管肝癌,一次超液态碘油剂量20～60mL。结果:98例患者接受大剂量超液态碘油栓塞化疗治疗,肝功能Child-Pugh A级者,肝功能损害不大,患者能耐受,与常规剂量栓塞组相比,无显著差别(P>0.05),其1～2、2～3、>3年生存率为77%、52.6％和18％,常规剂量栓塞治疗组为58.1％,32.5％和9％。大剂量超液态碘油栓塞较常规剂量栓塞治疗生存率高(P<0.05)。结论:大剂量碘油栓塞治疗巨块型富血管肝癌疗效较常规剂量栓塞治疗组好,其副作用无明显增加,该治疗方法可行。建议对肝功能 Child-Pugh A级者行大剂量超液态碘油栓塞治疗。

Transcatheter Embolism of Hepatic Arterial with High-dose Super-liquid Iodized Oil for Treatment of Large Mass and Abundant Vessel Type of Hepatocellular Cancer

Objective: To disscuss the curative effect of transcatheter artery chemoembolization (TACE) with high-dose super-liquid iodized oil for treatment of large mass and abundant vessel type of hepatocellular cancer. Methods: 98 cases of unresectable hepatocellular cancer in type of large mass and abundant vessel were treated with chemoembolization with high-dose super h'quid iodized oil (lipiodol, more than 20mL). Results: TACE with high-dost; lipiodol was tolerated by the treated patients whose hepatic function was of Child-Pulgh A stage, the frequence of post-treatment hepatic function insufficiency was not significantly different from that of patients treated with routine dose of h'piodol ( Kpiodol less than 20mL) , the 1 - 2 . 2 - 3, > 3year survival rate of patients in Child-Pugh A stage was 77%, 52. 6% and 18% , respectively, and more than that of the patients treated with routine dose of lip-iodol (58. 1% , 32.5% , 9%) ( P < 0.05). Conclusion: High dose super-liquid iodized oil TACE is a practicable and more efiective method for treatment of large mass and abundant vessel type of hepatocellular cancer as compared to the routine dose of h'piodol for TACE, but its use should be Limited to those patients with liver function in Child-Pulgh A stage.