经皮穿刺注射无水乙醇治疗高强度聚焦超声治疗后残留肝癌的疗效观察

目的探讨经皮穿刺注射无水乙醇治疗高强度聚焦超声(HIFU)后残留肝癌的疗效及其影响因素。方法对HIFU治疗肝癌术后的83例残留病灶进行无水乙醇注射(PEI)治疗。观察治疗前后患者临床症状、肿瘤标记物的变化,并用彩色多普勒血流显像(CDFI)定期随访肿瘤变化。结果79例患者临床症状明显改善。6个月和1、2年生存率分别为95.5%、82.5%、60.5%。CDFI随访,所有患者治疗区病灶回声增强,血供减少或消失,其中77例(92.8%)病灶体积缩小。51例AFP阳性患者中,46例(90.2%)AFP下降。结论HIFU联合无水乙醇能有效破坏肿瘤血供,灭活肿瘤,延长患者的生存期和提高生存质量,是肝癌非手术治疗的一种有效方法。

Evaluation of the therapeutic effect of PEI for residual hepat ocellular cancer after HIFU treatment

Objective To investigate the therapeutic effects and influencing factors of ultrasound-guided PEI for residual hepatocellular cancer after HIFU treatment.Methods 83 patients with hepatocellular cancer were treated with ultrasound-guided PEI followed by HIFU ablation.All patients were followed up.The changes of clinical symptoms and tumor markers were observed. The treated tumors were evaluated with CDFI before and after treatment.Results The symptoms were improved in 79 of 83 patients.The survival rates of 6 months,1year and 2 years were 95.5%,82.5% and 60.5% respectively.CDFI showed that the echoes in the treatment region increased and the blood flow decreased or disappeared.The treated masses shrunk obviously in 77 cases(93%).The serum AFP level decreased in 46 of 51 AFP positive primary hepatic carcinoma patients.Conclusion HIFU combined with PEI could interrupt the blood supply of the tumor effectualy and ablate it.This combination treatment method is an effective way for ablating hepatocellular carcinoma.