原发性肝癌介入治疗效果及严重并发症分析

Analysis of effects and severe complications of transcatheter arterial embolization of primary liver cancer

目的 探讨肝动脉化疗栓塞 (TAE)对原发性肝癌的疗效 ,并对严重并发症原因予以分析。方法选择原发性肝癌 3 96例 ,60 5次介入 ,观察疗效 ,记录并发症。结果 总体 1、2、3、4、5a生存率分别是 4 5 4 %、4 2 1%、19 2 %、2 3 %、1 3 % ,最长 1例存活 8a 3个月 ;严重并发症发生 2 1例 ,发生率为 5 3 % ,死亡 17例 ,病死率 81% ( 17/ 2 1) ;3 2例经TAE后行了Ⅱ期切除术 ;4 0例右肝巨大肝癌有异常血供。结论 TAE是中晚期肝癌有效的治疗方法 ;使部分病人可行Ⅱ期切除 ;但在行介入时应严格掌握指征 ,减少严重并发症发生 ,一旦发生 ,其病死率高 ,应引起高度重视 ;发现肿瘤异常血供并予以栓塞是提高疗效的措施之一。

Objective To evaluate the effects and analyze the causes of severe complications of transcatheter arterial embolization(TAE) of primary liver cancer (PLC). Methods TAE was performed in 396 patients of PLC, 605 times. The therapeutic effects were observed, and severe complications were written down. Results 1-,2-,3-,4-,5-year survival rate was 45.3%,42.1%,19.2%,2.3%,1.3% respectively. The longest survival period was 8 years and 3 months from the time of TAE. There were severe complications in 21 patients. The incidence was 5.3%. 17 patients died of severe complications, and the fatality rate was 81% (17/21). Stage Ⅱ surgical resections were performed in 32 patients after TAE. There were abnormal blood supply to tumor in 40 patients with right liver massive PLC. Conclusion TAE is effective in the treatment of moderate and advanced stages of PLC. Some patients gained chance of Stage Ⅱ surgical resections after TAE. Strictly selecting indications for TAE may reduce severe complications. They should be emphasized for their high fatality rate. Discovery and embolization of abnormal blood supply to PLC are the method improving effects of TAE.