经皮左锁骨下动脉植入药盒治疗中晚期肝癌

Percutaneous Implantation of Port-catherter System via Left Subclavian Artery Puncture for Treatment of Median or Advanced Liver Carcinoma

目的 :探讨经左锁骨下动脉留置导管药盒治疗肝癌的操作方法和临床价值。方法 :对 15例晚期原发性肝癌、4例多发转移性肝癌采用Seldinger技术经左锁骨下动脉植入药盒 ,留置管头端深置靶动脉内 ,药盒埋植在穿刺点外下方皮下 ,作肿瘤靶动脉内长期灌注治疗。结果 :19例导管药盒系统均 1次植入成功 ,术中无明显并发症 ;随访 1～ 12个月 ,死亡 2例、导管脱出 1例、导管阻塞 1例 ,术后病人生活质量和临床指标均有较明显改善。结论 :经皮左锁骨下动脉植入式药盒操作简单易行、成功率高且创伤小 ;药盒的植入给以后肿瘤靶动脉内长期灌往治疗提供了方便、有效的新途径。

Objective: To explore the procedure of per cu taneous implantation of port-catherter system (PCS) via left subclavian artery ( SCA) for treatment of advanced liver carcinoma, and evaluate the clinical effica cy. Methods: Nineteen patients were enrolled in this study includi ng 15 cases of median or advanced primary liver carcinoma and 4 cases of multipl e metastatic liver carcinoma. All patients were cathetered to the target arterie s via left SCA punctures with seldinger technique under DSA guidance. Subsequent ly, the PCSs were implanted under subcutaneous tissue proximal to left subclavia n areas for intermittent chemotherapy infusions to tumor vessels.Results: Nineteen PCSs were successfully implanted respectively, no complication was encountered during implantation procedure. Of the 19 patie nts receiving implantation of PCS, one had catheter dislocation, another had cat heter occlusion, two suffered death due to severe sickness, and the others s howed greater improvements of their life qualities and clinical index during 12 months'follow-up.Conclusion:The procedure of percutaneous implantation of PCS via left SCA puncture seems not only to be a safe and feasible approach, but also t o have higher successful rate and lower wounding. The implantation of PCS provid es a new avenue for long-time intermittent infusions to target tumor vessels.