经皮肝瘤内植入氟尿嘧啶植入剂治疗30例肝癌的疗效观察

Observation of 30 cases of hepatocellular carcinoma treated by percutaneous fluorouracil implants implantation

目的观察经皮肝穿刺瘤内植入氟尿嘧啶植入剂治疗肝癌临床疗效。方法2005年4月～2008年12月我们对30例直径1～5cm的肝癌患者实施经皮穿刺瘤内植入氟尿嘧啶植入剂治疗,通过CT联合数控穿刺引导仪的支持,对临床确诊的30例肝癌患者(35个病灶)瘤内植入中人氟安300～2 000mg。通过CT复查观察肿瘤病灶坏死情况。结果所有35个病灶经1次性治疗后均全部坏死,CT复查显示原病灶位置为边缘清晰之低密度灶,部分病灶可见高密度药物阴影,增强扫描无强化。30例患者,除3例死于肝功能衰竭和消化道出血,其余27例均无瘤生存。术中、术后出现轻、中度疼痛25例,术后出现胸腔积液2例,部分患者术后有肝功能改变,经对症处理1～2周恢复正常。结论在CT联合数控穿刺引导仪的支持下,氟尿嘧啶植入剂瘤内植入的间质化疗治疗晚期肝癌是安全有效的,值得临床推广应用。

Objective To observe the clinical effectiveness of percutaneous fluorouracil implants （FI） implantation in treating hepatocellular carcinoma. Methods Totally 30 patients with hepatocellular carcinoma confirmed by the pathological biopsy underwent the percutaneous FI implantation from April 2005 to December 2008. The dosage ranged from 300 mg to 2000 rag. The clinical results were proven by the CT observations. Results All the nudulars under the therapy were necrotized after the single treatment, and no enhancement appeared in the area of necrosis under CT observations. Three patients died of fulminant hepatic failure and gastrointestinal bleeding, and the remaining 27 patients survived free of tumours. No severe complications occurred. Conclusion Percutaneous FI implantation is safe and effective for the treat- ment against hepatoeellular carcinoma.