门静脉右支结扎及肝动脉右支置管治疗巨大右肝癌2例及文献复习

Right portal vein ligation and right hepatic artery tube indwelling to treat huge right hepatic carcinoma

目的:探讨不可切除巨大肝癌的有效治疗手段。方法:对两例巨大右肝癌患者施行门静脉右支结扎和肝右动脉结扎并置管栓塞化疗,比较术前术后甲胎蛋白变化情况和复查肝脏CT片结果。结果:两例患者自觉症状术后均迅速消失。病例1AFP由术前45ng/L,在术后1月降为2ng/L,胆红素及转氨酶曾一过性轻度升高,出现少到中量腹水,未处理自行消退。病例2术前AFP为大于1000ng/L,术后1周降为700ng/L,转氨酶最高354IU/L,胆红素最高231μmol/L,大量腹水,经积极处理后恢复。CT扫描结果显示原肿瘤位置被液性暗区替代。结论:门静脉右支结扎和肝右动脉结扎并置管栓塞化疗是治疗巨大右肝癌有效的方法,效果确切,费用低。

Objective：To study effective method for huge unresectable hepatic carcinoma. Methods：To perform right portal vein ligation and right hepatic artery tube indwelling for 2 patients with huge hepatic carcinoma, and observe the changes of AFP and liver CT. Results： CT scan revealed that fluid sonolucent area replaces area of tumor in liver;In one case, AFP decreased from 45 ng/L at pre - operation to 2ng/L at post - operation, BIL and aminopherase increased slightly. In the other patient, AFP decreased from 1000ng/L to 700ng/L, BIL up to 354IU/L, aminopherase 231 μmol/L. Conclusion：Portal vein ligation and chemoembolization by right hepatic artery tube indwelling are effective method to treat hepatic carcinoma.