彩色多普勒超声对经动脉灌注碳酸氢钠和维拉帕米提高肝癌肝动脉栓塞化疗疗效研究

目的　研究二维及彩色多普勒血流显像 (CDFI)在对肝癌患者进行肝动脉化疗及栓塞术 (TAE)中 ,经动脉灌注碳酸氢钠和维拉帕米的可行性和临床价值 ,评价对白细胞介素 -2 (IL -2 )、干扰素 (IFN -α 2b)和阿霉素(ADM )、丝裂霉素 (MMC)等药物的增效作用。方法　 3 8例肝癌患者在进行肝动脉化疗及栓塞术时联合碳酸氢钠、维拉帕米、IL -2IFN -α 2b介入治疗。Seldinger技术穿刺经股动脉进入肝动脉血管 ,药物按一定比例稀释后灌注 ,二维及彩色多普勒超声分别于治疗前后测量肿瘤位置、大小、回声情况、肿瘤周边及内部血供情况 ,肝动脉血流动力学改变 ,全程跟踪上述新的治疗方法 ,并结合临床资料综合判断疗效。同期肝癌患者TAE治疗未加碳酸氢钠和维拉帕米作为对照组。结果　经动脉灌注碳酸氢钠和维拉帕米治疗肝癌患者部份缓解率高于对照组 ,二维及彩色多普勒超声表现为肝癌肿块减小 ,肿瘤内部及周边动脉血供和肝动脉血流量明显减少 ,α -FP下降 ,生存时间延长。结论　肝癌患者行TAE治疗时向肿瘤组织灌注碳酸氢钠、维拉帕米可提高IL -2、IFN -α 2b、ADM、MMC等疗效 ,而二维及彩色多普勒超声能对上述新的TAE的疗效和预后提供重要指标 ,给下一步重复治疗提供依据 ,是目前肝癌肝动脉化疗及栓塞治疗前后良好影像学检?

Study on arterial infusion of NaHCO3 and verapamil to improve effects of transcatheter arterial embolization(TAE)in hepatocarcinoma by color Dopple ultrasonography

Objective To study the possibility and effects of transcatheter arterial embolization (TAE) through arterial infusion of NaHCO 3 and verapamil in Hepatocarcinoma by color dopple ultrasonography,and evaluate its improving effects on IL-2,IFN-α2b,ADM,and MMC.Methods 38 patients having Hepatocarcinoma were treated by TAE,meanwhile,they were treated by arterial perfusion of IL-2,IFN-α2b,ADM,and MMC combined with NaHCO 3 and verapamil.Using seldinger technique to enter hepatic artery through puncturing femoral arteries,then drugs were infused into them at reasonable concentration.The location,size,echo,blood supply of tumers and the changes of hepatic hemodynamics were observed by CDFI.Results The partial remission rate of therapeutic group with arterial infusion of NaHCO 3 and verapamil was higher than that of the contral group.CDFI showed that tumers became smaller in size,the supply of tumers and also the livers were decreased,the level of α-FP were restricted,and the lifetime of those patients were extended.Conclusions Arterial infusion of IL-2,IFN-α2b,ADM,and MMC combined with NaHCO 3 and verapamil can improve their effects on Hepatocarcinoma patients.CDFI is a reliable method to provide some important information of the therapeutic effects of TAE and can also provide some indexes in the following treatment.