肝动脉栓塞术治疗原发性肝癌30例

HEPATIC EMBOLIZATION IN 30 PATIENTS WITH PRIMARY LIVER CANCER

30例原发性肝癌进行了35次肝动脉栓塞治疗。栓塞的方法有超选择肝动脉栓塞和经腹腔动脉行肝脾动脉栓塞。栓塞材料有明胶海绵、硅橡胶、碘苯脂等。肝癌栓塞范围为50%～90%.术后结果显示大部患者 AFP 下降,肝脏缩小,已死亡组中位生存期为296.6天,最长为1080天.结果提示肝动脉栓塞术可作为治疗肝癌的一种姑息疗法,但疗效与肿瘤的临床分期和分型有密切关系。具有明显肝肾功能损害的患者不宜作栓塞治疗。超选择肝动脉栓塞优于肝脾动脉联合栓塞.明胶海绵、碘苯脂和抗癌药联合应用是良好的栓塞材料。

Hepatic embolization has been performed 35 times in 30 patients with primary livercancer since 1982.Methods of embolization included superselective hepatic arterialocclusion and occlusion of hepatic and splenic arteries from celiac artery.About 50—90%of the tumor blood supply was occluded.After embolization,most patients showed decreasein AFP level,reduction in liver size and improvement in clinical symptoms.The averagesurvival time before death after embolization was 296.6 days with the longest 1080 days.The results suggest that hepatic embolization may be a good palliative treatment for livercancer but the outcome is significantly related with the type and stage of the lesion andthe method of occlusion.Severe impairment of liver or renal function is a contraindica-tion to embolization.Combination of gelfoam,mydil and anticancer drugs yields goodembolizing effects.