原发性肝癌术后介入治疗疗效观察(附32例分析)

The curative effect observation on transcatheter arterial embolization of hepatocellular carcinoma after surgical resection:Analysis of 32 cases

目的探讨术后行肝动脉栓塞化疗的方法及其对减少原发性肝癌术后复发、提高生存率的价值。方法对32例原发性肝癌术后患者,20～90天内行肝动脉造影,根据造影情况予以不同剂量的碘油加化疗药物栓塞治疗。结果32例中8例发现10处复发病灶。予以超选择栓塞化疗,2周及1个月行肝脏CT复查,示病灶内碘油沉积良好,经1～3次介入治疗后,病灶缩小稳定。复查所有32例患者AFP降至正常或继续阴性。随访20～48个月,无一例肝内有新病灶发现。结论原发性肝癌术后行预防性介入治疗,针对不同造影情况施以不同剂量的碘油加化疗药物治疗,可以尽早发现复发病灶并治疗,对于尚未复发病例,亦能达到预防性治疗的目的。

Objective To reduce the recurrent of hepatocellular carcinoma (HCC) after surgical resection and improve the patient's life rate by investigating the role of chemoembolization for the treatment of HCC after surgical resection.Methods Thirty-two patients with HCC were treated with angiography on 20th to 90th day after operation.All cases were received a TAE therapy,according the result of angiography,the dose of the iodized oil and chemomedicine were different.Result Ten recurrent lesions were detected in eight patients.These eight patients were treated by TAE with superselective cannulation and followed up by abdomen CT examination two to four weeks after first TAE.Image of CT showed well accumutation of iodized oil within lesions.After one to three times treatment,the lesions reopt stable.In all thirty-two patients,AFP values recovered to normal or remained negative after therapy.Following up 20 to 48 months,no new lesion was discovered.Conclusion The treatment of the preventative TAE for the patients of HCC by receiving the therapy with different dose of iodized oil and chemomedicine in accordance with the result of the angiography can detect and treat the lesions early.It can also attain the goal of preventative treatment to the non-recurrent cases.