超声引导微波热凝联合无水乙醇注射和门脾静脉灌注对肝癌的治疗研究

Multiple ultrasound interventional therapy study of cancer of the liver treatment

目的：探讨综合性超声介入疗法对中晚期肝癌的疗效。方法：50例经活检证实的肝癌依据肿瘤的大小和数目分为：一组。肿块直经〈3．0cm，个数〈2个。二组：肿块直径3．1—5．0cm，个数〈2个。三组：肿块直径〉5．0cm，个数≥1。超声引导下经皮经肝穿刺肿瘤，分别采用单纯微波热凝（PMCT）（方案1a）、或单纯无水乙醇肿瘤间质内注射（PEIT）（方案1b）、微波热凝＋无水乙醇肿瘤间质内注射（方案2）、微波热凝＋无水乙醇肿瘤间质内注射＋门（脾）静脉穿刺灌注化学药物（方案3）。不同的介入治疗方法。治疗后定期行超声、CT、肝穿活检、随访观察其疗效并加以比较。随访时间10个月至5年。结果：直经〈3．0cm，个数〈2个小肝癌单纯微波热凝和单纯无水乙醇注射1、2、3、年生存率无差异。肿块直经3．0-5．0cm者方案2优于方案1a、1b。肿块〉5．0cm多结节肝癌或伴门脉癌栓者，方案3优于方案2。综合性介入治疗肝癌的总有效率均高于方案1a和方案1b。结论：该方案设计合理，疗效确切，操作便利，安全可靠，费用低，值的推广。

Objective ： To design a kind of ultrasound intervenfional therapy . Apply it to the treatment of the difl＇erent size and the numbet of the cancer of the liver and approach it＇s the proper plan.Methods： Reviewing analysis variable ultrasound interposal therapy to the curative effect of the cancer of liver microwave hot solidity. A lot of plans ultrasound interposal therapies are adopted the prove of the caneer of liver on 50 eases biopsy according to the tumors＇ size and number, they are divided： group one： d 〈 3.0cm, n 〈 2. two： d = 3.1 - 5.0cm, n〈2. three：d〉 5.0cm, n≥1. They are adopted pure microwave hot solidity （la plan）, or pare anhydrous alcohol injection part in tumor （lb plan ）, microwave hot solidity＋ anhydrous alcohol injection in tumor （plan 2）, microwave hot solidity ＋ anhydrous alcohol injection in tumor＋ portal vein（spleen） puncture ehemoiberapy （-plan 3）. After treatment, fixed carrying out CT, liver puncture walking exam, often visit its therapy of cure, and making comparison, visiting time： 10 months-5 years.Results：d〈 3.0cm, n〈 2 cancer pure miewave hot solidity and pure anhydrous alcohol injefiun in tumor, 1,2,3 ）＊ear survival rate no difference. Tumor d 3.1 - 5.0cm patients plan 2 is better than plan hi and lb. Tumor d 〉 5.0cm multimass or peartal vein invasion patients, plan 3 advantadges that plan 2. Comprehensive interposal cure cancer total effective rate is higher than plan ia, lb. Conclusion：This plan is designed reasonably and its curative effect is correct, simple operation lower cost. It is worth developing.