经皮肝穿刺注射无水乙醇配合肝动脉化疗栓塞术治疗原发性肝癌

Combined percutaneous ethanol injection through liver puncture and transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma

目的 研究B超引导下经皮肝穿刺注射无水乙醇 (percutaneousethanolinjection ,PEI)配合肝动脉化疗栓塞术 (transcatheterhepaticarterialchemoembolization ,TACE)治疗原发性肝癌的疗效。方法 原发性肝癌 87例 ,其中TACE组 45例 ,TACE +PEI组 42例。结果 TACE组 1,2 ,3年生存率分别为 6 6 .7%、41.2 %和 2 1.4% ,组织学检查仅 2 6 .1%的病变完全坏死 ;TACE +PEI组 1,2 ,3年生存率分别为 97.1%、85 .7%和 6 5 .7% ,组织学检查 81.8%的病变完全坏死。两组间在生存率和肿瘤完全坏死率间差异均有显著性 (P <0 .0 5 )。结论 对于原发性肝癌 ,TACE +PEI疗效优于单纯TACE ,是一种较好的综合治疗方法。

Objective To study the therapeutic effects of transcatheter arterial chemoembolization (TACE) combined with beta ultrasound guided percutaneous ethanol injection(PEI) at multiple points for hepatocellular carcinoma.Methods Eighty seven patients with hepatocellular carcinoma were divided into two groups: Group A, 45 patients were treated with TACE only, group B, 42 patients were treated with TACE plus PEI.Results In group A patients, the 1 , 2 , and 3 year survival rates were 66.7%, 41.4%, and 21.4%, respectively. Only 26.1% of cancer specimens showed complete necrosis by pathologic examination in group A. In group B, the 1 , 2 , and 3 year survival rates were 97.1%, 85.71% and 65.71%, respectively, with complete necrosis in 81.8%.Conclusion The therapeutic effects of transcatheter arterial chemoembolization combined with percutaneous multiple point ethanol injection through liver puncture is much better than that of TACE alone. [