新型明胶海绵颗粒栓塞剂在肝癌介入治疗中的应用

Application of gelatin sponge particles to the interventional treatment of hepatic carcinoma

目的:观察新型明胶海绵颗粒栓塞剂经导管肝动脉化疗栓塞治疗肝癌的近期疗效。方法:2008年10月-2009年6月,我院50例原发性肝癌患者行明胶海绵微粒联合肝动脉化疗栓塞术治疗。术后结合生化及影像学检查,观察和总结临床疗效与不良反应。结果:本组50例原发性肝癌患者有效率(CR+PR)为40.0%,获益率(CR+PR+NC)为86.0%;术后3 d CT见肿瘤密度降低,部分呈蜂窝状坏死,术后1个月肿瘤缩小甚至完全液化坏死;术后7 d患者肝功能指标与术前比较没有统计学差别;43例AFP阳性患者,AFP在术后3 d即明显下降,25例术后1个月恢复正常,转阴率为58.1%;没有发现与明胶海绵微粒有关的异位栓塞等严重并发症发生。结论:新型明胶海绵微粒联合肝动脉化疗栓塞治疗肝癌疗效确切,而且肝功能损伤较轻、有关的不良反应少见,为临床治疗肝癌提供了一个良好的选择。

Objective： To evaluate the short-term clinical effect of the gelatin sponge particles on transcatheter hepatic arterial chemoembolization for hepatic carcinoma.Methods：From October 2008 to July 2009,50 hepatic carcinoma patients were cured by TACE with gelatin sponge particles in our hospital.With chemical examination and imaging tests,the clinical effect and adverse reactions were observed and evaluated.Results： The positive response rate of this group of 50 patients with primary liver cancer was 40.0%（CR＋PR）,benefiting rate（CR＋PR＋NC） was 86.0%,3 days after tumor density,the honeycomb was observed to be necrosis by CT,tumor size was reduced after a month or even liquefaction necrosis.There were not statistically different in liver function parameters between before and 7 days after operation.43 patients of AFP-positive patients obtained significant decrease of AFP at 3 days after the operation.25 patients returned to normal level after 1 month.Negative conversion rate was 58.1%.No patient had serious adverse reaction such as ectopic embolization,related with gelatin sponge particles.Conclusion：The gelatin sponge particles are excellent embolization agent with better clinical effect in the treatment of hepatic carcinoma,and with less liver damage and adverse reaction.