超声引导下经门静脉栓塞治疗原发性肝癌

目的 探讨经门静脉化疗栓塞术治疗原发性肝癌的可行性及其临床疗效.方法 选取经肝动脉化疗栓塞术(TACE)治疗效果不理想的原发性肝癌患者30例共49个癌灶,行经门静脉介入化疗(TPCE),对肿瘤行化疗栓塞术.结果 28例中成功施行经门静脉化疗栓塞术26例共46个病灶.治疗前、治疗后1个月、3个月的平均肝功能Child评分分别为(9.8±2.4)分、(9.3±2.1)分和(8.1±1.9)分,治疗后1个月、3个月AFP>400μg/L的患者比例及AFP测值均显著低于治疗前(P<0.05);综合B超和CT结果示治疗后1个月、3个月时肿瘤病灶的完全毁损率分别为86.4%、94.9%.结论 经门静脉化疗栓塞术治疗肝癌操作简单,安全有效,可作为对TACE疗效不佳的肝癌患者的一种治疗手段.

Clinical investigation on the combination treatment of primary liver carcinoma with trans-portal vein chemoembolization

Objective To inquire into the feasibility and clinical effect of the combination treatment for pri-mary liver carcinoma with trans-portal vein chemoembolization(TPCE). Methods 30 eases of primary liver carcino-ma with 49 neoplasms, who had acquired poor therapeutic effieacies from the treatment of transcatheter arterial chemoembolizalion(TACE) ,were collected and treated with TPCE. Results Of the 28 eases,26 cases with 46 neo-plasms were successfully administered with TPCE. The Child scores of liver function of pre-treatment, 1,3 month of post-treatment were (9.8 ± 2.4), (9.3 ± 2.1 ) and (8.1 ± 1.9 ), respectively. The ratios of the cases of AFP >400μg/L and the determined values of AFP were significantly lower in 1st and 3rd month after the treatment than those of pre-treatment( P < 0.05) ;in the comprehensive analysis of B-ultrusound and CT results, 86.4 % of the neo-plasms were thoroughly ablated at 1 month after the treatment. The relapsing and unthoroughly ablated neoplasms were continuously treated with TPCE. The thoroughly ablating rate was 94.4 % till 3 months after the treatment.Conclusion The combination treatment of TPCE is simply-operated,safe,effective for the primary liver carcinoma,and it can be an alternative treatment for the patients who got poor therapeutic efficacies from the TACE.