CT导引双介入疗法治疗肝癌

CT guided double intervention therapy in the treatment of hepatocarcinoma

目的评价ＣＴ导引双介入疗法治疗肝癌的效果。方法１５０例肝癌患者中６４例行单纯经导管肝动脉内含碘化油明胶海绵化疗栓塞术（ＬｐＧｓＴＡＥ），８６例行ＣＴ导引双介入治疗（ＣＴＤＩＴ），即指经皮肝肿瘤内无水乙醇注射（ＰＥＩ）和ＬｐＧｓＴＡＥ方法的联合应用。观察两组的疗效和生存率。结果ＣＴＤＩＴ组完全缓解率为６２８％，ＬｐＧｓＴＡＥ组为３７５％，ＣＴＤＩＴ组疗效优于ＬｐＧｓＴＡＥ组；两组病死率比较，ＣＴＤＩＴ组低于ＬｐＧｓＴＡＥ组，差异有极显著意义。结论采用ＬｐＧｓＴＡＥ治疗肝癌有一定局限性，而采用ＣＴＤＩＴ治疗可弥补其不足。尤其对于不能手术的肝癌。

Objective To evaluate the effectiveness of treating hepatocarcinoma with CT guided double intervention therapy (CT DIT). Methods 64 cases of hepatocarcinoma were treated with transcatheter hepatic artery lipiodol and gelfoam chemoembolization (LpGsTAE), 86 cases of hepatocarcinoma were treated with CT guided percutaneous absolute ethyl alcohol injection (PEI) as well as transcatheter hepatic artery lipiodol and gelfoam chemoembolization (CT DIT). The therapeutic effectiveness and survival rate were observed. Results The rate of complete remission was 62.8% in the CT DIT group, while it was 37.5% in the LpGsTAE group. CT DIT is more effective than LpGsTAE ( P <0.01). The fatality rate in the CT DIT group was lower than that in the LpGsTAE group, with significant difference between the two groups. Conclusion The treatment therapy of hepatocarcinoma with LpGsTAE has its limitation circumscription. CT DIT can cover the deficit of either LpGsTAE or PEI alone. So it is an effective and safe method for treating hepatocarcinoma that cannot be excised.