经皮穿刺无水乙醇消融术治疗原发性肝癌及肝外转移灶的临床观察

Percutaneons ethanol injection for primary hepatic carcinoma and extrahepatic metastases:clinical observation

目的探讨经皮穿刺无水乙醇消融术在原发性肝癌(PHC)及肝外转移灶治疗中的应用及意义。方法回顾性分析67例PHC及部分伴有肺转移、腹腔淋巴结转移的患者临床资料。67例中,肝内病灶83个;肺转移灶53个(31例);腹腔淋巴结转移22个(16例)。肝内病灶采用经皮肝动脉化疗栓塞术和(或)无水乙醇消融术治疗,肝外转移病灶采用单纯无水乙醇消融术,术后3个月复查CT平扫或增强以评价疗效。结果全组肿瘤病灶有效率65.8%,肝内病灶有效率67.5%,肺转移灶有效率60.4%,腹腔淋巴结转移灶有效率72.7%,半年及1年生存率分别为83.5%和59.7%。结论无水乙醇消融术在PHC及肝外转移灶的治疗中具有较好的应用价值。

Objective To discuss the clinical application and significance of percutaneons ethanol injection（PEI） in treating primary hepatocellular carcinoma（HCC） and its extrahepatic metastases.Methods Sixty-seven patients with primary HCC were treated with PEI and the clinical data were retrospectively analyzed.A total of 83 primary hepatic lesions were detected in 67 patients,while 53 lung metastases were found in 31 patients and 22 lymphatic metastases in 16 patients.The hepatic lesions were treated by transcatheter hepatic arterial chemoembolization（TACE） and /or PEI.The extra-hepatic lesions were treated by PEI.The curative effect was evaluated with plain or enhanced CT scanning at 3 months after the treatment.Results The effective rates for hepatic lesions,lung metastases and abdominal lymph node metastases were 67.5%,60.4% and 72.7%,respectively.The survival rates at half and one year after the treatment were 83.5% and 59.7%,respectively.Conclusion For the treatment of primary HCC and its extrahepatic metastases,PEI is of higher clinical value.