改进介入化疗栓塞术治疗肝癌合并肝动脉-门静脉瘘的效果探讨

The clinical effects of improved transcatheter arterial chemoembolization in the treatment of hepatic carcino-ma with HAPF

目的：探讨改进介入化疗栓塞术（ TACE）治疗肝癌合并肝动脉-门静脉瘘（ HAPF）的临床疗效。方法选择肝癌合并HAPF患者110例，按数字法随机分为观察组55例和对照组55例，对照组患者行传统的TACE，观察组患者行改进TACE，术后随访3个月，比较两组患者碘油沉积情况。结果观察组中央型肝癌合并HAPF的碘油沉积良好率为75．0％（18/24），显著优于对照组的42．3％（11/26）（χ2＝4．325，P＝0.036）；观察组周围型碘油沉积良好率为71．0％（22/31），与对照组的72．4％（21/29）差异无统计学意义（χ2＝3．268，P＝0．073）。结论改进TACE能有效增加中央型肝癌合并HAPF的碘油沉积率，对周围型肝癌合并HAPF的碘油沉积率与传统的TACE比较影响不大，故适用于在中央型肝癌患者中推广使用。

Objective To observe the clinical effects of improved transcatheter arterial chemoembolization （ TACE） in the treatment of hepatic carcinoma with HAPF .Methods 110 patients with different types of hepatic carcinoma with HAPF were randomly divided into the observation group （55 cases） and the control group（55 cases）. The patients of the control group were given conventional TACE ,and the patients of the observation group were given improved TACE.All the patients were followed up for 3 months,the lipiodol deposition was observed and compared between the two groups .Results In the patients of the observation group with central hepatic carcinoma with HAPF ,the good rate of lipiodol deposition was 75.0%（18/24）,which was significantly higher than 42.3% of the control group（11/26）,the difference was statistically significant （χ2 =4.325,P=0.036）.In the patients of the observation group with surrounding hepatic carcinoma with HAPF ,the good rate of lipiodol deposition was 71.0%（22/31）,which in the control group was 72.4%（21/29）,the difference was not statistically significant （χ2 =3.268,P=0.073）. Conclusion Improved TACE can effectively increase the lipiodol deposition rate of central hepatic carcinoma with HAPF,but it has little effect in increasing the lipiodol deposition rate of surrounding hepatic carcinoma with HAPF ,it suitable to be applied in the patients with central hepatic carcinoma .