应用新三明治栓塞法治疗巨块型肝癌疗效观察

The observation of the new sandwich TACE in treating massive hepatocellular carcinoma

目的:探讨新三明治栓塞法治疗巨块型肝癌的疗效。方法:常规使用Seldinger技术送入导管,先行血管造影,后选择性送入供血动脉内,注入栓塞剂。A组90例,采用先注入碘化油乳剂至病灶基本栓塞,再注入颗粒栓塞剂栓塞供血动脉;B组90例采用先注入碘化油乳剂总量1/2～2/3,再注入颗粒栓塞剂,使血流变缓,再注入剩余碘化油乳剂。结果:TACE术后,A组完全栓塞者85例,再次行TACE时则显示肿瘤"残留现象"76.7%,B组全部栓塞完全,再次行TACE时显示肿瘤"残留现象"者为35.6%。随访1年A组共有53例,B组共有18例出现肝内或远处转移。1年生存率A组为77.8%,B组为87%。结论:应用"新三明治"栓塞法治疗巨块型肝癌疗效显著。

Objective：To evaluate the curative effect of massive hepatocellar carcinoma with the new sandwich transcather arterial chemoembolization（TACE）. Methods： Seldinger technique was used. Firsdy, anglography was performed, then the embolic agents were selectively delivered into the artery. Group A included 90 cases. Firsdy, iodized oil emulsion was injected into the lesions until em- bolized, and then the particle embolic agents were injected; group B included 90 eases, firstly, 1/2 - 2/3 of the total iodized oil emul- sion were injected into the lesions, and then the Granule embolic agents were injected, so that blood flow slowed, and then the remainder of iodized oil emulsions was injected.Results：After TACE, 85 cases from group A were completely embollzed, when TACE performed again, the tumor ＂residual phenomenon＂ rate was 76.7%. The group B was embolized completely. Once again, the incident rate of ＂remant phenomenon＂ was 35.6%. During one year follow-up, intra-hepatic and/or distant metastasis were found in 53 cases in Group A and 18 cases in Group B. The one-year survival rate was 77.8%in Group A and 87% in Group B. Conclusion：The new sandwich TACE has remarkable therapeutic value in treating massive hepatoeareinoma.