原发性肝癌经皮肝动脉药物灌注和栓塞治疗

Percutaneous Hepatic Artery infusion and Embolization in the Treatment of Hepatoma

本文收集了44例、年龄26～70岁,全部经AFP、B超、CT及血管造影证实均符合原发性肝癌诊断标准的一组病例,行67次肝动脉灌注化疗(HAI)和/或肝动脉栓塞治疗(HAE),其中5例辅以原发灶和转移灶的酒精硬化治疗并行随访观察;结果全部病例自觉症状改善,5例腹水和黄疸消失,2例黑便消失,1例锁骨上和腹股沟转移淋巴结软化,66.7％肝脏有不同程度缩小,16.8％保持稳定,一年以上随访的11例中6例存活超过一年,生存超过6个月的占64.7％,经上述治疗后有4例中晚期肝癌重新获得手术切除。介入治疗对中晚期肝癌是一项极其有效的方法。本组全部病例治疗后症状均改善,提高了生存质量。治疗方法以联合治疗最佳,特别对巨块及结节型伴或不伴转移者,辅以原发灶和转移灶酒精硬化治疗,其疗效明显提高。

Forty-four patients,age 26~70, with hepatocellular carcinoma verified by AFP, US, CT and angi-ography,were given 67 times hepatic artery infusion ( HAI ) and-lor hepatic artery embolization (HAE) . Among them, 5 eases were also treated by Percutaneous ethanol injecton of the tumor or metastases. After the treatment, all patients' symptoms were improved, jaundice and ascites in 5 cases disappeared, the liver sizes were reduced in different degree (66.7%). The survival rate of six months or more and a year or more is 64.7% and 54.5% respectively. 4 patients acquired the opportunity of resection again. Intercurrent management is v-ery effective in patients with hep-atoma. In this series all patients' symptoms and quality of life were improved. The best way is the c-ombined treatment, especially using the ethanol injection of tumor and metastases, the curative effect is increased obviously.