彩超引导门静脉化疗结合瘤内无水酒精注射在中晚期肝癌中的临床应用

目的：探讨彩超引导下经皮经肝选择性门静脉化疗(SPVC)结合瘤内无水酒精注射疗法(PEIT)联合肝动脉栓塞化疗(TACE)治疗中晚期肝癌的临床应用价值。方珐：28例不能手术的中晚期肝癌，在TACE基础上，行彩超引导下作SPVC结合PEIT。观察治疗前后肿瘤大小，血供变化，声像图改变及甲胎蛋白(AFP)的变化与临床疗效的关系。结果：肿瘤血供消失和减少率92．9％，肿瘤缩小率89．3％，AFP转阴率60.7％，门静脉癌栓消失和减少率68．7％。结论：彩超引导下选择性门静脉化疗结合瘤内无水酒精注射联合TACE对预防肝癌转移，延迟复发，及改善预后有肯定意义，明显延长病人带瘤生存期和提高了生活质量。

CLINICAL APPLICATION OF SPVC WITH PEIT GUIDED BY COLOR DOPPLER ULTRASOUND IN THE ADVANCED HEPATIC CANCER

objective: To evaluate the clinical significance of selective portal vein chemotherapy (SPVC) and percutaneous ethanol injection therapy (PEIT) guided by color Doppler ultrasonography (CDU) after transhepatic arterial chemo-embolization (TACE). Methods: Twenty eight cases of unresectable middle and advanced stage hepatic carcinoma were treated by SPVC and PEIT after TACE under the guidance of CDU and observed the changes of blood supply and size of tumor, the sonographic characteristics and the clinical effect before and after treatments. Results: The rate of disappearing and reducing of blood supply was 92.9%, the tumor mass shrinkage rate was 89.3%, and AFP negative reversion rate reached 60.7%, the rate of disappearing and reducing of portal vein tumor thrombosis was 68.7%. Conclusion: Ultrasound-guided SPVC and PEIT after TACE has positive significance for preventing from recurrence and improving prognosis, obviously prolonging survival time and improving survival quality.