介入治疗后生存二年的肝癌病例分析

Analyses on the Two-year-survival Patients with Hepatoma after Interventional Therapy

目的:回顾性地分析介入治疗后生存两年以上的54例肝癌病人,旨在探研影响介入治疗后患者长期生存率的相关因素.资料和方法:共54例,男、女各47、7例,年龄24～69岁,平均50岁,52例原发性肝癌,2例转移性肝癌.分析肝癌的类型、部位、大小、血供性、肝脏的 Child 氏分级、治疗方式及治疗次数等.结果:肿块为单结节、多结节和巨块型者各3、5、和46例.肿瘤大小情况:小于10cm 者28例,大于10cm 而小于15cm 者18例,大于15cm 而小于20cm 者6例,大于20cm 者2例.肿瘤血供呈富血性、中等富血及少血性者分别为39、12、1例.Child 氏分级 A、B、C 级分别为48、5、1例.治疗方式:①灌注加栓塞者48例;②灌注加单纯碘油栓塞3例,③灌注并内膜下栓塞者2例;④单纯灌注者1例.结论:肝癌病人介入治疗后的长期疗效与下列因素呈正相关:①肿瘤呈膨胀性生长,肿块<10～15cm;②富血性;⑧有包膜;④远离侧支循环丰富区域;⑤基础肝脏功能;⑨末梢性栓塞;⑦栓塞之永久性和⑧综合施治等.

Retrospectively,54,two-year-survival patients with hepatoma after interventional therapy was analysed,we investigated the relevant factors which might affected the long-term survival rates.The results suggested that the long-term survival rates are found to be in direct proportion to the following factors:(1)Expansile growth style of the tumor and the mass diameter is less than 10 to 15cm;(2)Tumor heperneo- vascularity;(3)Tumor capsula;(4)Remoteness from the rich collateral areas;(5) Good ground liver function;(6)Distal embolixation;(7)Embolization eternity;and (8)synthetical treatment.The indication of interventional therapy,optimixation of therapeutic methods,assessment of the prognosis in patients with hepatoma,and the QA,QC problems of interventional treatment were discussed.