超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓

Percutaneous ethanol injection combined with microwave ablation for treatment of tumor thrombus of the portal vein branch under ultrasonography

目的探讨超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓的技术可行性及其疗效。方法报道2005年2月至2007年9月收治的37例原发性肝癌切除术后单发性门静脉分支癌栓行超声引导经皮肝穿注射无水酒精联合微波固化37例的疗效。无水酒精治疗每周1次,连续4周,第5周微波固化1次。随访时间12个月。结果治疗后6个月5例血清甲胎蛋白转阴,13例低于治疗前水平。7例癌栓缩小,25例出现癌栓生长静止期;无效组5例癌栓范围扩大或合并肿瘤转移。治疗后随访6个月和12个月总存活率分别为86.5%和62.2%。结论超声引导经皮肝穿注射无水酒精联合微波固化治疗门静脉分支癌栓的技术可行,有一定疗效,可延长患者生存时间。

Objective To assess the curative effect of interventional ultrasound in treatment of the tumor thrombus of the portal vein branch with petcutaneous ethanol injection combined with microwave ablation. Methods From February 2005 to September 2007, 37 patients with portal vein branch tumor thrombus were treated by percutaneous absolute ethanol injection combined with microwave ablation guided by ultrasound. The ethanol injection was carried out once a week for four weeks; the microwave ablation was performed at the following week for the body of tumor thrombus. The patients were followed up for 12 months. Results Six months post operation, serum α-fetal protein turned to be negative in 5 patients, improved in13 patients, and the size of tumor thrombus became small in 7 patients and suspended in 25 patients. But the treatment was not effective in 5 patients since their lesions continued to grow or metastize. The 6- and 12-month total survival rates were 86.5% and 62.2% respectively. Conclusion Percutaneous ethanol injection combined with microwave ablation is effective for the treatment of tumor thrombus of the portal vein branch guided by ultrasound.