肝癌合并门静脉高压的局部消融治疗

随着多种治疗方法的综合应用,原发性肝癌患者生存期不断延长。对于合并门静脉高压的早期肝癌患者,局部消融治疗可达到长期生存,并在稳定门静脉压力,保存肝脏功能,减少并发症等方面具有积极的作用。此外,局部消融可以和经肝动脉化疗栓塞术、经颈内静脉肝内门体分流术、脾切除、贲门周围血管离断术等方法相结合,进一步提高疗效。围手术期客观评价门静脉压力,预防食管胃底静脉曲张破裂出血,纠正脾功能亢进和防止术后肝衰竭,做好多学科团队协作管理,有助于提升消融后患者的管理效率。

Advances in local ablation therapy for liver cancer with portal hypertension

With the comprehensive application of a variety of treatment methods,the survival time of patients with primary liver cancer is gradually increasing.For patients with early-stage liver cancer and portal hypertension,local ablation therapy can achieve long-term survival and play a positive role in stabilizing portal venous pressure,preserving liver function,and reducing complications.In addition,it can be combined with other techniques such as transarterial chemoembolization,transjugular intrahepatic portosystemic shunt,splenectomy,and pericardial devascularization to further improve treatment outcome.Several measures can be taken in the perioperative period to improve the management efficiency of patients after ablation,such as objective evaluation of portal venous pressure,prevention of esophagogastric variceal bleeding,correction of hypersplenism,prevention of postoperative liver failure,and multidisciplinary team management.