大剂量加热碘油栓塞治疗巨大肝癌的临床疗效

Clinical Curative Effect of High-dose Thermo-lipiodol Embolization in Treatment of Huge Hepatocellular Carcinoma

目的:探讨大剂量加热碘油栓塞治疗巨大肝癌的疗效。方法:216例巨大肝癌患者,分成A、B 2组:A组(加热组)112例,用大剂量加热碘油经肝动脉行栓塞术;B组(常温组)104例,使用常温大剂量碘油经肝动脉行栓塞术;所有患者均在术前经B超、CT、MRI及AFP确诊为肝癌,病灶直径11～19 cm,碘油用量15～40 mL。评价病灶的缩小情况、存活时间和AFP的变化。结果:A组和B组肿瘤缩小和AFP变化的比较均有显著性差异(P<0.05)。随访6～36个月,A组生存率:6个月96.42%(108)、12个月83.04%(93)、18个月72.32%(81)、24个月51.79%(58)、36个月33.93%(38);B组生存率:6个月82.69%(86)、12个月68.27%(71)、18个月58.65%(61)、24个月41.35%(43)、36个月13.46%(14)。结论:大剂量加热碘油栓塞治疗巨大肝癌效果优于常温组,旦安全有效。

Objective To study the curative effect of high-dose thermo-lipiodol embolization for treatment of huge hepatocellular carcinoma.Methods 216 patients with huge hepatocellular carcinoma were divided into A and B groups.Group A（heating group） was given with transcatheter arterial high-dose thermo-lipiodol embolization,and Group B（control group） with transcatheter arterial high-dose thermo-lipiodol embolization under normal temperature.All of the patients should be diagnosed as hepatocellular carcinoma by B-ultrasonography,CT,MRI and AFP in advance,with a nidus diameter between 11 and 19cm and iodipin consumption between 15 and 40mL.The lessened focus,survival time and AFP changes were evaluated.Results There were significant differences between Group A and B（P 0.05）.36-month follow-up was performed.The survival rate of Group A was 96.42%,83.04%,72.32%,51.79% or 33.93% respectively at the 6th,12th,18th,24th and 36th month,and the corresponding number was 108,93,81,58 or 38.The survival rate of Group B was 82.69%,68.27%,58.65%,41.35% or 13.46% respectively at the 6th,12th,18th,24th and 36th month,and the corresponding number was 86,71,61,43 or 14.Conclusion The effect of High-dose thermo-lipiodol embolization in treatment of huge hepatocellular is better than that under normal temperature.