肝癌伴随疾病的介入治疗

Interventional treatment of accompanied diseases of hepatocarcinoma:A study on the feasibility and clinical value

目的探讨原发性肝癌伴随疾病的介入治疗的可行性及其临床价值。方法对60例肝癌伴随各种疾病,分别采用Seldinger技术及经皮肝穿刺行介入治疗,对脾功能亢进及食管胃底静脉出血行栓塞术,对恶性梗阻性黄疸行引流及再通术。结果总有效率为100%,脾功能亢进者症状减轻,白细胞和血小板术后24h即有明显改善;恶性梗阻性黄疸者术后15d复查总胆红素,17例由150～900μmol/L降至19～45μmol/L,行内支架者生存期为18个月。食管胃底静脉破裂出血者行经皮肝穿刺门静脉食管胃底静脉栓塞术,有效控制出血,挽救了患者的生命。结论介入治疗肝癌伴随疾病微创、安全有效,是在外科无法手术时首选的方法。

Objective To investigate the clinical value and feasibility in the treatment of accompanied diseases of primary hepatocarcinoma by the interventional therapy. Method The 60 cases of this diseases were underwent interventional treament by Seldinger＇ technical and percutaneous per-hepatic catheterization.Among them 10 cases who were suffer from varices hemorrhage of stomach fundus and 20 cases from hypersplenism were performed recanalizatlon and percutaneous drainage and placement mental stent. Results The total efficiency rate was 100%.The symptom with hypersplenism was allevited immediately after embolization.The numbers of leukocytes and blood platelets counts were improved clearly 24h after operation,The level of total serum bilirubin in 17 cases with malignant biliary obstruction were varied from 150-900μmol/L to 19-45μmol/L.The survival time was prolonged to 18 months after placemented stent.Percutaneous per-hepatic catheter embolization of the varices vessel could effectively control the gastric bleeding, Conclusion The interventional therapy would become the first choice especially in these no chance for surgery,it is an efficient and safe method in the treatment of accompanied diseases of primary hepatocarcinoma.