肝动脉栓塞加部分脾栓塞治疗原发性肝癌伴脾亢的临床研究

Clinical Study on Therapeutic Arterial Chemo-Embolization Combined With Partial Splenic Embalization Applied to Treat the Hepatocellular Carcinoma Compared With Hypersplenism

目的 测定原发性肝癌伴肝硬化脾亢患者行肝动脉化疗栓塞 (TAE)加部分脾栓塞 (PSE)与单纯肝动脉化疗栓塞的效果与不良反应。方法 3 6例用TAE +PSE ;3 2例单用TAE。结果 肝动脉化疗栓塞加部分脾栓塞疗效满意。TAE +PSE组放射学证明有效的为 3 3例 ( 91 7% ) ;其中 ,PR 3 2 7% ( 11/3 6) ;单用TAE为 71 8% ,其中PR 2 1 8% ( 7/3 2 )。观察血常规、肝功能及各项免疫指标 ,发现该组血细胞下降较单纯肝动脉化疗栓塞组明显减少 ,两组比较有显著差异 (P <0 0 1) ,肝动脉化疗栓塞加部分脾栓塞组治疗前后肝功能改善也较单纯肝动脉化疗栓塞组明显。结论 肝动脉化疗栓塞加部分脾栓塞对治疗原发性肝癌伴肝硬化脾亢患者有效 ,值得进一步研究。

Objective To determine the effects and side effets of therapeutic arterial embolization(TAE) combined partial splenic chemo embolization(PSCE) and single TAE in the treatment of patients of hepatocellular carcinoma with hypersplenism. Methods Efficacy of 36 patients with TAE plus PSE; 32 patients with single TAE were observed.Results The research revealed good that the TAE combined with PSCE treatment had a good efficacy. 33 patients(91 7%) had radiographic evidence that the response to treatment, of them PR(paritial remission), was 32 7%(11/36) in the TAE plus PSCE group; but 71 88% of them, PR was 21 8(7/32) in single TAE group (P<0 05),The reduction of blood cell counts in single TAE group was lower than TAE plus PSCE group by detection of dynamic blood cell counts; liver function and immunological index. The difference statistically of two groups was observed.Conclusions TAE combined with PSE group is significantly superior to single TAE group It indicates that the PSCE combined with TAE treatment is effectiveness for hepatocellular carcinoma compared with hypersplenism.Further investigation of this regimen is warranted.