经左锁骨下动脉PCS留置术治疗TAE后残余肝癌

从1994年8月～1996年4月，我们对35例中、晚期肝癌患者进行了经左锁骨下动脉药盒导管系统（PCS）植入术，与先前进行的肝动脉栓塞相结合，通过药盒导管系统作规律的肝动脉灌注化疗。12例单发巨块型肝癌患者半年生存本达100％，1年生存率为83.3％，其中7例生存超过2年．23例多发或弥漫型肝癌患者半年生存率为86．9％，1年生存率为55.5％．我们认为，肝动脉栓塞后留置PCS能保证化疗的规律性，从而有效控制栓塞后残余病灶的复发．肝动脉灌注化疗的次数、化疗药物剂量和化疗灌注方法的合理安然可提高疗效．本文还对左锁骨下动脉的经皮穿刺技术和插管方法提出一些体会和经验．

The Useage of Percutaneous Trans-subclavian Arterial Implatation of Port-Catheter System in the Treatment to Hepatic Carcinoma aftet Trans-Arterial Embolizations

From Aug. 1994 to Apr. 1996 we performed the implantations of percutaneous trans-subclavian-arterial port-catheter system(PCS) in 35 patients with hepatic carcinoma in moderate and advanced stage. Combining with the hepatic arteral embolization, the regular hepatic arterial infusions through PCS might be hclpful to improve the con ditions of these patients. In 12 caes with single giant mass,the halr-year survival rate reached to 100%,one- year survival rate was 83.3%, 7 patients lived over 2years. In 23 cases wi th multiple or disseminated focuses, the half-year survival rate was 86.9% and the one-year survival rate was 55.5%. We consider that the use of the implantations of PCS after TAE can make the regular chemotherapy to the residual tumors possible,then the recurrance is effectively under control. We also think that the times of HAI, the dosage of the chemoagents and the rational arrangement of infusions may enhance the treatment effect.This paper also comments some experiences about the percutaneous transsubclavian paracentesis and the catheterizations.