经桡动脉途径对肝癌患者行亚叶酸/5-氟尿嘧啶/奥沙利铂肝动脉持续灌注化疗的临床应用

Clinical application of hepatic arterial infusion chemotherapy via radial artery access by using FOLFOX scheme in treating patients with liver cancer

目的 探讨经桡动脉(radial artery, RA)途径行亚叶酸/5-氟尿嘧啶/奥沙利铂(folinic acid/5-fluorouracil/oxaliplatin, FOLFOX)-肝动脉持续灌注化疗(hepatic artery infusion chemotherapy, HAIC)的可行性及安全性。方法 回顾性分析行2周期FOLFOX-HAIC治疗的肝癌患者140例,其中经桡动脉途径60例,经股动脉(femoral artery, FA)途径80例。观察并记录两组患者的手术时间及辐射剂量,穿刺和手术成功率,术中、术后并发症发生情况。结果 RA组60例患者中,52(86.67%)例成功置管化疗,FA组80例(100%)均成功置管化疗,差异有统计学意义(P<0.05)。在手术时间和患者所受辐射剂量方面,RA组高于FA组(P<0.05)。RA组和FA组术后并发症发生率为19.23%和20.00%,差异无统计学意义(P>0.05)。RA组患者在HAIC过程中也可下床活动。结论 采用经RA途径行FOLFOX-HAIC术安全、可行,患者舒适性明显提高,但在手术难度、手术操作时长及辐射剂量方面存在一定的不足。

Objective To discuss the feasibility and safety of hepatic arterial infusion chemotherapy(HAIC)via radial artery(RA)access by using folinic acid/5-fluorouracil/oxaliplatin(FOLFOX)scheme in treating patients with liver cancer.Methods The clinical data of a total of 140 patients with liver cancer,who had received 2 cycles of FOLFOX-HAIC treatment,were retrospectively analyzed.Of the 140 patients,via RA access was adopted in 60(RA group)and via femoral artery(FA)access was adopted in 80(FA group).The time spent for procedure,the radiation dose,the success rate of puncturing and surgery,and the intraoperative and postoperative complications were recorded.Results In RA group and FA group,the successful catheterization plus HAIC was accomplished in 52 patients(86.67%)and 80 patients(100%)respectively,the difference between the two groups was statistically significant(P<0.05).The time spent for procedure and the radiation dose in RA group were remarkably higher than those in FA group(P<0.05).No statistically significant difference in the incidence of postoperative complications existed between the two groups(19.23%vs 20.00%,P>0.05).During HAIC,the patients in the RA group could get out of bed for daily activities.Conclusion FOLFOX-HAIC via RA access is clinically safe and feasible,it can remarkably improve the comfort degree of patients,but it also carries some certain shortcomings such as the high difficulty of manipulation,the long time spent for the surgical procedure,and the high radiation dose received by the patients.