经肝动脉留置导管持续灌注榄香稀治疗存在肝动静脉或肝动脉门脉瘘的肝癌

Hepatic cancer with arteovenous or arteroportal leak: hepatic arterial continuous elemene perfusion with retaining catheter

目的探讨榄香稀持续灌注治疗存在肝动静脉或肝动脉门脉瘘的肝癌的疗效。方法62例存在肝动静脉或肝动脉门脉瘘的肝癌患者给予榄香稀经肝动脉留置导管持续灌注治疗。术后定期复查ALT、AST、T-BIL、WBC、AFP等指标以评价肝功能及肿瘤变化,同时还行肝脏CT或MRI及经肝动脉造影观察肿瘤体积、数目的变化及瘘口封堵情况。结果35例(56%)患者肝动脉造影显示原有的瘘口基本闭塞,同时AFP的数值亦有所降低;17例(27%)患者肿瘤体积明显缩小(>50%)。12例(19%)患者生存期超过24个月,其余50例(81%)患者生存期为7～15个月。结论经肝动脉留置导管持续灌注榄香稀治疗存在肝动静脉或肝动脉门脉瘘的肝癌是一种既有效封堵瘘口又最大程度灭活肿瘤的治疗方法。

Objective To investigate the clinical efficacy of hepatic arterial continous elemene perfusion in the treatnieut of hepatic cancer with arteriovenous or arterioportal leak. Methods 62 cases of hepatic cancer with arteriovenous or arterioportal leak were treated with retaining catheter hepatic arterial continuous elemene perfusion. The levels of ALT, AST, T-BIL, WBC, AFP were all used for investigation of liver function and tumor remission. CTA or MRI and hepatic arterial angiography were also performed for investigation of tumor remission, including the volume and numbers and closure of the leak. Results 35 cases （56%）achieved the closure of leak demonstrating by hepatic arteriography with simultaneous decrease of AFP. 17 cases （27%）showed obvious shrinkage of the volume of tumor（ 〉 50% ）. 12 cases （19%）enjoyed more than 24 months＇ survival, the rest 50 cases （81%）achieved 7-15 mouths survival. Conclusion Hepatic arterial continuous elemene perfusion with retaining catheter for treating hepatic cancer with A-V or A-P leak is not only effective for leak closure but also possessing a maximum annihilation for the tumor.