原发性肝癌介入治疗中小颗粒性栓塞剂的合理使用

目的观察、分析肝动脉化疗栓塞后“血管门残留现象”成因,寻求对策。方法60例块状型原发性肝癌患者,分别采用常规方法栓塞（A组,n=30）,小颗粒栓塞（B组,n=30）。观察两组残留现象的发生率及中期疗效。结果治疗后即时,A组“残留现象”占86．7％,B组占43．3％有明显差异（P〈0．01）,A组一年生存率为60％,B组为83．3％。结论肿瘤动脉插入式供血血管门区域血管管径粗血流速度快、相对容易形成侧支血供和常规栓塞治疗中常出现的假性完全性栓塞为“残留现象”的主要形成原因。

Reasonable use of shortgrained embolization in interventional therapy of primary carcinoma liver

Objective To observe the tumor hilar remnant phenomenon(THRP) after transcatheter arterial chemoembolization, and to analyze the fators of its formation, in order to find a countermeasure of reatment.Methods There were 60 patients with primary hepatocellular carcinoma of massive type. The c ases in early stage were treated by conventional TACE (Group A, n=30), shortgrained embolization (Group B, n=30) The incident rate of (THRP) and the effects of therapy were compared between the two groups. Results The incident rate of THRP was 86.7% in Group A and 43.3% in Group B(P<0.01) just agter the first time. The oneyear survival rate was 60% in Group A and 83.3 % in Group B. Conclusion The main factors of THRP formation include thc inserted feeding tumor arteries, the bigger vessel diameter and the faster blood flow in the hilar of tumor,the easier collateral bllod supply, and the false complete TACE which is usually to be found in conventional TACE.