肝癌术后肝血管造影及介入治疗临床价值

Hepatocellular carcinoma after livrr angiographu and interventionaltherapy clinical value

目的:探讨原发性肝癌术后行肝动脉栓塞化疗的方法及其对减少原发性肝癌术后复发、提高生存率的价值。方法:对45例原发性肝癌术后患者,20-90天内行肝动脉造影,根据造影情况予以不同剂量的碘油加化疗药物栓塞治疗。结果:45例共行182次,平均4.0次介入治疗,1例于8年内行17次介入治疗。39例发现复发病灶,其中29例在介入术前经B超、CT/MRI、AFP等检查未发现明确复发病灶,即29例复发病例是通过DSA发现的,另10例在介入术前经B超、CT/MRI和AFP等检查临床已明确肝内复发,6例DSA未发现复发病灶。39例复发病例中,有7例患者为术后1个月内行介入治疗。在介入后随访中,39例复发病例,其中10例只作1次介入治疗,8例病灶缩小、稳定,2例病灶消失;6例阴性病例中有2例复发,复发分别发生在第2次和第4次介入治疗,距离首次介入治疗时间分别为10和15个月。对肝癌高危人群中AFP显著或持续增高、超声或/和MSCT检查未发现明确病变或疑似肝癌的病例,行DSA造影。结论:原发性肝癌术后常规行预防性介入治疗,针对不同造影情况施以不同剂量的碘油加化疗药物治疗,可以尽早发现复发病灶并治疗,对于尚未复发病例,亦能达到预防性治疗的目的。

Objective：To reduce the recurrent of hepatocellular carcinoma（ HCC）after surgical resection by che-moembolization for HCC after surgical resection. Methods：All 45 cases of HCC were treated with angiography on 20th to 90th day after operation. All cases received TAE therapy,according the result of angiography,the dose of the io-dized oil and chemomedicine were different. Results：All 45 cases underwent 182 times,an average of 4 times of inter-ventional treatment. In 39 cases with recurrent lesions,including 29 cases in the intervention of the BUS,CT/MRI, AFP examination revealed no recurrence of lesions,29 cases of recurrence was detected by DSA,another 10 cases by B ultrasound in the interventional preoperativem,CT or MRI and AFP examination had recurrence,6 cases of DSA showed no recurrent lesions. 39 cases of recurrence,7 patients for interventional treatment for 1 month after opera-tion. In follow-up,39 cases with recurrence,of which 10 cases only had 1 time of interventional treatment,8 cases were reduced,stability,disappeared in 2 cases;2 cases recurred in 6 cases,recurrence occurred in second and fourth times of interventional treatment. Conclusion：The treatment of preventative TAE for the patients of HCC with iodized oil and chemomedicine is effective for early lesions.