微波消融结合门静脉灌注治疗肝癌合并门静脉癌栓的临床观察

目的探讨超声引导经皮微波消融结合门静脉灌注化疗治疗对肝癌合并门静脉癌栓的疗效。方法选择59例原发性肝癌合并门静脉主干或门静脉左右分支癌栓的患者分成两组，观察组30例采用微波消融结合门静脉灌注化疗治疗；对照组29例单纯行微波治疗。治疗后定期对所有患者进行超声造影及肝癌血清学指标癌胚抗原（AFP）、门静脉癌栓检测，比较两组患者疗效并随访患者生存率。结果观察组0．5、1、2、3年复发率明显低于对照组（P〈0．05），门静脉癌栓缩小率、AFP转阴率明显高于对照组，差异有统计学意义（P〈0．05）。观察组0．5、1、2、3年生存率明显高于对照组，差异有统计学意义（P〈0．05）。结论超声引导经皮微波消融加门静脉灌注化疗对肝癌合并门静脉癌栓疗效明显并可延长患者生存期，是一种安全有效的微创综合治疗方法。

Clinical observation of microwave ablation combined with portal vein perfusion chemotherapy in the treatment of hepatoceHular carcinoma combined with portal vein tumor thrombus

Objective To investigate the therapeutic effects of percutaneous microwave ablation under ultrasound guid- ance combined with portal vein perfusion chemotherapy in the treatment of hepatocellular carcinoma （HCC） combined with portal vein tumor thrombus （pVrlT）. Methods 59 eases of patients with HCC and PVTY in the main trunk or the first branch of portal vein were randomly divided into two groups. 30 cases in the observation group were treated with microwave ablation and PVTY. 29 cases in the control group were treated with microwave ablation alone. The contrast- enhanced ultrasound （CEUS）, serum fetoprotein （AFP）, portal vein tumor thrombus were detected, and the curative ef- fects and survival rates of the two groups were compared. Results The 0.5, 1, 2, 3 years recurrence rates of the obser- vation group were significantly lower than those of the control group （/9 〈 0.05）. The PVTT minification rate and the AFP negative rate of the observavation group were significantly higher than those of the control group （P 〈 0.05）. The 0.5, 1, 2, 3 years survival rate of the observation group were significantly higher than those of the control group, the differences were statistically significant （P 〈 0.05）. Conclusion Percutaneous microwave ablation under ultrasound guidance combined with portal vein perfusion chemotherapy can improve the curative effect of HCC combined with PVTT and increase patients＇ survival rate, which is a valuable microinvasive method.