CT引导经皮靶向综合治疗晚期肝癌的临床应用价值

The Clinical Value of CT-guided Percutaneous Comprehensive Targeting Treatment in the Advanced Hepatocellular Carcinoma

目的:探讨CT引导下经皮靶向穿刺,瘤体内化疗、放疗、血管栓塞综合治疗晚期肝癌的效果及其临床应用价值。方法:在CT引导下经皮以肿瘤作靶向定位穿刺,经针管向瘤体内灌注化疗、放疗药加栓塞剂对40例晚期肝癌进行局部综合性治疗,并在操作技术、治疗作用与副作用、有效率、生存率方面与经股动脉插管至肝动脉化疗栓塞(TA- CE)作比较。结果:CT引导穿刺操作简易,快捷安全,微创损伤轻。副作用小。适用于对大多数晚期肝癌的治疗。本组病例治疗后,半年生存率:77.5%,1年生存率:35%,2年生存率:15%。总有效率:80%。经股动脉插管至肝动脉或超选择到肝动脉分支操作复杂,技术难度高,治疗时间长。禁忌症多。椐文献资料显示,用(TACE)治疗大肝癌的1年生存率:27.5%。2生存率:14.7%。结论:CT引导经皮靶向综合治疗晚期肝癌行之有效,副毒作用轻,安全,适用范围广,操作优于(TACE)治疗。

Objective： To investigate the CT-guided percutaneous puncture targeting tumor in vivo chemotherapy, radiotherapy, blood clots integrative treatment of advanced liver cancer and the effect of clinical value. Methods： With CT-guided percutaneous for tumor targeting positioning puncture, to syringe to lump in vivo irrigation chemotherapy, the radiotherapy medicine and embolism suppository provides 40 patients with advanced hepatocellular carcinoma with local integrative treatment. And to compare the operation technology, therapeutic effect and side effects , efficient, survival rate with those of the femoral artery catheterization to hepatic arterial chemo-embollzation （TACE）. Results： CT-guided puncture simple, safe and fast, minimally invasive injury light, Side effects, suitable to the majority of advanced liver cancer treatment. The patients after treatment, haft a year survival rate： 77.5%, l-year survival rate： 35%, 2-year survival rate： 15%. The total efficiency： 80%. The Selected femoral artery catheterization to the liver or super-hepatic artery branches is operatedly complex and technically difficult, for a long treatment period, many contraindications. As noted in the literature data, using （TACE） in the treatment of large hepatocellular carcinoma 1 year survival rate： 27.5%. 2 survival rate： 14.7%. Conclusion： CT-gulded percutaneous treatment of advanced hepatocellular carcinoma integrative targeting is effective, toxic effects light, security, and suitable to a wide range of operations than （TACE） in the treatment.