彩色多普勒超声引导下经皮门静脉穿刺留置导管的临床应用

Clinical application of transhepatic portal vein catheterization under ultrasonic guidance in the treatment of patients with primary and metastatic liver carcinoma

目的探讨彩色多普勒超声引导下经皮经肝穿刺门静脉留置导管的临床应用价值。方法100例肝细胞癌或转移癌患者,在彩色多普勒超声引导下经皮经肝穿刺门静脉置入中心静脉导管,观察穿刺及置管成功率、导管留置天数、并发症发生率和治疗效果。结果在100例患者中,穿刺一次成功率和置管一次成功率为98.0%;早期导管留置天数为7～14d,平均9.2±2.7d,改进后为23～60d,平均44.7±13.5d;无严重并发症发生。经门静脉注药治疗原发性肝癌和转移性肝癌的疗效优于外周静脉给药。讨论该方法可重复门静脉给药,能增加局部药物浓度,提高药物治疗的效果,并且安全、可靠,无严重并发症。

Objective To study the clinical application of transhepatic portal vein catheterization under ultrasonic guidance in the treatment of patients with primary and metastatic liver carcinoma. Methods 100 patients with primary and metastatic liver carcinoma underwent transhepatic portal vein catheterization under ultrasonic guidance. Results Of the 100 cases,the success rate of puncture was 96.92%. The catheter in portal vein at the early stage was 7 to 14 days （ 9.2±2.7 days on average）, while 23 to 60days （ 44.7 ± 13.5 on average） when the technique improved. The efficacy of chemotherapy via transhepatic portal vein catheterization for patients with hepatoma was superior to conventional peripheral vein administration. Conclusions The method could be repeatedly used for intraportal administration of drugs and enhance the effects. It is safe,reliable with no serious complications and worth being applied.