肝动脉、门静脉栓塞化疗治疗不可切除的原发性肝癌

目的：探讨肝动脉、门静脉双管栓塞化疗对不可切除的原发性肝癌的治疗作用。方法：对19例不可切除的原发性肝癌患者采用手术方法向肝动脉、门静脉植入皮下埋藏式投药泵，术中即开始经肝动脉投药泵栓塞化疗，术后7－10d在X线监测下经门静脉投药泵栓塞化疗，以后定期经两投药泵栓塞化疗，术后观AFP的变化、Bus或CT检查并与同期3次以上的32例HACE进行比较。结果：双栓化疗组17例术后1月AFP均下降、3月下降为正常8例，84．2％的肿瘤缩小，6月、9月、12月、24月生存率分别为89．5％、78．9％、68．4％、31．6％，中位生存期17．1月，其中2例进行了二期手术切除。HACE组术后1月AFP下降10例、3月后下降21例，46．9％的肿瘤缩小，6月、9月、12月、24月生存率分别为71．9％、53．1％、31．3％，中位生存期11．2月、12月、24月生存率组间比较P＜0．01；两组均无异位栓塞。结论：皮下埋藏式投药泵肝动脉、门静脉双插管栓塞化疗术后给药途径简单、方便、疗效好、并发症少，是治疗不可切除的肝癌有效方法之一。

TREATMENT OF UNRESECTABLE PRIMARY HEPATIC CARCINOMA WITH EMBOLIZATION AND CHEMOTHERAPY VIA HEPATIC ARTERY AND PORTAL VEIN

Objective To study the therapeutic effect of hepatic artery and portal vein dual perfusion embolization and chemotherapy for unresectable primary hepatic carcinoma.Methods Retrospective analysis was used to study the clinical data of 19 patients with unresectable PHC treated by embolization via hepatic artery and portal vein through drug pumps.The hypodermic implanted artery and portal vein through drug pump began during laparotomy,while embolization and chemotherapy via portal vein through drug pump were fulfille from the 7 th day to 10 th day postoperation under the survey of x rays.Afterwards embolization and chemotherapy through the dual drug pumps were used at intervals.The variations of postoperational AFP,Bus and CT,were compared with those of 32 patients treated with HACE for at least 3 times.Results The of level AFP in 17 cases treated with dual embloization and chemotherapy decreased 1 month later after the operation and 84.2% tumors decreased.the 6,9,12,24 months survival rate was 89.5%,78.9%,68.4%,31.6%,respectively with a 17.1 months median survival time.Two cases received the secondary-stage operated.In HACE group,AFP decreased 1 months postoperation in 10 cases ,3 months in 21..46.9% tumors decreased with 6,9,12,24 months survival rate bing 71.9%,53.1%,31.3%,3.1% respectively and the median survival time 11.2 months.12,24 months survival rate were significantly different between the two groups(P<0.01)?There was no paradoxical embolization in the two groups.Conclusion Embolization and chemotherapy via hepatic and portal vein through dual hypodermic implanted drug delivery pumps was simple convenience,effective and less complicationed.It was one of effective therapeutic methods for unresectable hepatic carcinoma.