肝动脉联合门静脉栓塞化疗治疗原发性肝癌23例观察

23 Cases of hepatic artery combined with portal vein chemoembolization for hepatocellular carcinoma

目的评价肝动脉联合门静脉化疗栓塞治疗原发性肝癌的临床价值。方法回顾性我院临床和(或)活检明确诊断、行肝动脉联合门静脉化疗栓塞术治疗的原发性肝癌23例,术后通过观察瘤体大小、碘油沉积、正常肝组织代偿情况及甲胎蛋白水平等指标及随访生存率来评价疗效。结果 23例中14例介入治疗后瘤体缩小,其中缩小>50%有8例,5例无明显变化,4例增大。11例碘油沉积>50%,其中充填致密者6例。介入术后所有患者正常肝组织有代偿性增大,4例患者术后择期行二期手术切除。16例介入术后AFP有不同程度下降,9例降至正常。电话随访23例患者6个月、1年、2年及3年生存率分别为91.3%、73.9%、39.1%、17.4%。结论肝动脉联合门静脉化疗栓塞术是治疗原发性肝癌的较为有效的方法,可以诱导肝叶代偿性增生,改善肝功能,并有利于肿瘤进行二期切除,延长了患者的生存期。

Objective Evaluation of hepatic artery the joint portal vein chemoembolization clinical value in the treatment of primary liver cancer . Methods Retrospective clinical and （or） biopsy diagnosis of hepatic artery with portal vein chemoembolization of primary liver cancer and 23 cases of postoperative tumor size by observing lipiodol deposition, normal liver tissue compensatory circumstances and A fetoprotein level indicators and follow-up survival evaluated. Results After interventional treatment of 23 cases, 14 cases of tumor regression, which reduced 〉 50% of the eight cases, five cases no significant changes, increases in four cases. 11 cases of of lipiodol deposition 〉 50% , which filled with dense six cases. Compensatory increase interventional postoperative patients with normal liver tissue, 4 patients undergoing elective two surgical resection. 16 cases after Interventional AFP decreased to varying degrees, nine cases to normal. Telephone follow-up of 23 patients, 6 months, 1 year, 2-year and 3-year survival rates were 91. 3% , 73.9% , 39.1 % , 17.4%. Conclusion Hepatic artery portal vein chemoembolization is a more effective method for the treatment of primary liver cancer can be induced hepatic lobe compensatory hyperplasia, improve liver function, and is conducive to the the tumor resection two, prolong the survival of patients.