介入治疗中晚期肝癌61例临床分析

Evaluation of Interventional therapy for middile and advanced stages of hepatic carcinoma in 61 cases

目的：探讨对不能手术切除的中晚期肝癌经导管动脉灌注化疗栓塞术（TACE）治疗的效果。方法：对不能手术切除的61例中晚期肝癌患者行经导管动脉灌注化疗栓塞术，治疗后评价疗效并随访两年，观察其生存率。结果：61例患者多数病例症状改善，生活质量明显提高。32例患者介入术后肿瘤有不同程度缩小，其中2例患者肿块完全消失，肿块缩小50％以上者11例，缩小低于50％者19例，无明显变化15例。随访6～24个月，死亡43例，其中34例死于肝衰，5例死于上消化道出血及癌转移，3例死于肝内瘤体破裂出血，1例死于急性胆囊炎。存活1年以上29例，生存率约47．5％，存活两年以上18例，两年生存率约29．5％。结论：对失去手术机会的肝癌串者．存条件弁许情况下，行灌注和栓塞治疗是行之有效的治疗方法。

Objective： To evaluate the effects of transcatheter arterial chemoembolization （TACE） for the patients with advanced inoperable hepatic carcinoma. Methods： TACE were performed in 60 patients with advanced hepatic carcinoma who were not suitable for operation via femoral artery catheterization with Seldinger＇s technique. After treatment we observed the survival rate and follow up a case by regular visits to two years after operation. Results： Most patient among 60 patients improved their symptom after transcatheter arterial chemoembolization （TACE）, life quality obviously improved as a result. Among them the lump shrinked accounting for 56. 5%, follow up a case by regular visits to 6-24 months, 43 cases were dead, 34 of 43 cases died from liver failure, 5 cases died of metastasis of cancer and upper gastrointestinal hemorrhage, 3 cases of liver tumour body broken bleeding, 1 case died of acute cholecystitis. 29 people survived more than one year,the survive rate was 47.5%. 18 people survived for two years and more, about 29.5% of two year survival rate. Conclusion： As a result treatment ,The TACE is an effectual treatment methods to whom losing the operation chance under the condition is allowed.