介入治疗贲门癌伴肝转移24例临床观察

目的:探讨肝固有动脉+胃左动脉化疗栓塞术治疗贲门癌伴肝转移患者的临床应用价值。方法:对24例贲门癌伴肝转移的首治患者,采用Seldinger穿刺插管技术,选取:5-Fu、ADM(EADM、THP)、DDP(L-OHP)、MMC中的2～3种灌注,胃左动脉选用明胶海绵栓塞,肝固有动脉则采用超液碘化油栓塞。结果:第2次介入治疗4周后进行评价。除3例仅做1次介入治疗患者,治疗后吞咽困难:0级2例、Ⅰ级6例、Ⅱ级10例、Ⅲ级2例、Ⅳ级1例;生存质量:差2例、一般4例、较好10例、良好5例;疗效评价:CR0例、PR14例、SD17例、PD3例,有效率8.3%;生存期1、2、3、4年分别为75.0%、37.5%、12.5%、4.2%。结论:对贲门癌肝转移的患者,行肝固有动脉+胃左动脉化疗栓塞术,具有改善吞咽困难症状、提高生存质量、延长生存期、疗效相对满意、不良反应可控制、适宜人群广的优点,应推广应用于临床。

Objective：To srudy cardiac carinoma patients with hepatic arery chemotherapy ＋ left gastric artery embolization for the clinical application value. Metheds：24 cases of cardia carcinoma with liver metastases were the first medical treatment. Cannulation using Seldinger puncture technipue, select ： 5 - Fu, ADM （ EADM, THP）, DDP （ L - OHP）, MMC infusion of 2 - 3 drugs. Selection of the second evaluation after 4 weeks. Only three cases, good 5 cases. Short - term efficacy ： CR 0, PR 14cases, SD 17 cases,PD 3 cases,The effective rate was 58. 3%. Thel -. 2 -, 3 -,4 - year survival rates were175.0%, 317.5%, 12. 5%, 4. 2%. Conclusion：To patients wyth liver metastasis of life, the survival period, adverse reations can be controlled, and suitable for people of the advantages of wide. Clinical application should be extended.