肝动脉插管和结扎治疗不能切除肝癌的评价

目的：评价肝动脉插管（HAI）和结扎（HAL）治疗不能切除原发性肝癌的价值。方法：比较分析258例不能切除肝癌行HAI和HAL、90例肝癌行姑息性的生存率。结果：HAI和HAL组无术后死亡。HAI组（33例）1年生存率为0；HAI＋HAL组（185例）1、3和5年生存率分别为71.3％、43.9％和29.7％，其中有28例（15.1％）获二期切除；HAI＋HAL十术中冷冻、微波等治疗组（40例）1、3和5年生存率分别为83.6％、57.9％和57.9％，其中有6例（15.0％）获二期切除。同期姑息性肝切除（90例）术后死亡率为2.2％（2/90），1、3和5年生存率分别为72．7％、43.6％和32.3％。结论：HAI＋HAL是治疗不能切除肝癌的安全有效方法，结合其它综合治疗可进一步提高远期疗效。

The Evaluation of Hepatic Artery Infusion and Ligation for Unresectable Primary Hepatic Cancer

Objective: To appraise the value of hepatic artery infusion (HAI) and ligation (HAL) for unresectable primary liver cancer. Methods: the post - operative survival rates of HAI and HAL (n = 258) were compared with that of palliative resection (n = 90). Results: There was no post - operative death in HAI and HAL group. The 1 year survival rate of HAI group (n= 33) was 0. The 1, 3 and 5 year survival rates of HAI HAL group (n = 185) were 71. 3 %, 43. 9 % and 29. 7 %, respectively. Of this group, two - stage resection was performed in 28 patients (15. 1 % ). The 1, 3 and 5 year survival rates of HAI HAL cryosurgery or microwave therapy group (n = 40) were 83. 6 %, 57. 9 % and 57. 9 %, respectively. Of this group, two - stage resection was performed in 6 patients (15. 0 % ). In palliative resection group (n = 90), the post - operative mortality rate was 2. 2 % (2/90). The 1, 3 and 5 year survival rates were 72. 7 %, 43. 6 % and 32. 3 %, respectively. Conclusions: HAI HAL is an effective and safe treatment for unresectable liver cancer. Long - term survival may be improved after combination therapy.