三丙烯微球在原发性肝癌动脉栓塞治疗中的应用研究

Three acrylic microspheres in primary hepatic artery embolization treatment applied research

目的:评价三丙烯微球(Embosphere)作为动脉栓塞剂的栓塞性能,观察Embosphere微球联合碘化油进行栓塞治疗原发性肝癌的疗效。方法:选择原发性肝癌患者50例,将微导管超选择至肿瘤供血动脉,用碘油化疗药物混合乳剂进行肿瘤微循环血管栓塞,再用直径500～700μm的Embosphere微球2～4ml栓塞肿瘤供血小动脉,透视下观察血流明显减慢或血管铸型时停止。每隔一个月进行肝脏增强CT或增强MRI检查随访,查AFP及肝功能,观察临床疗效。结果:全组50例患者经过2～5次治疗后均有明显好转,随访5～36个月,其中2例肿瘤小于5cm的患者经过3～4次治疗临床症状消失,肿瘤临床治愈,AFP正常,超过3个月疗效评价CR。29例经过2～5次治疗临床症状好转,肿瘤缩小,AFP下降明显均在20～500μg/L,超过3个月疗效评价PR,17例患者肿瘤较大,经过治疗后肿瘤无明显变化,疗效评价NC,2例患者为肿瘤巨大,伴有肝内多发转移,经过治疗肿瘤仍有进展,疗效为PD,有效率(CR+PR)为62%,获益率(CP+PR+NC)为96%。结论:Embosphere微球作为一种新型栓塞材料在原发性肝癌动脉栓塞治疗中,临床疗效显著,安全性好,性能优越,值得推广和应用。

Objective evaluation of three acrylic microspheres(Embosphere) as the artery embolization agent embolism performance,observation of Embosphere microsphere combined with embolization in treatment of primary liver cancer.Methods Patients with primary liver cancer 50 cases,the microcatheter superselective to tumor feeding artery,using lipiodol emulsion mixture of chemotherapy of tumor microcirculation vascular embolism,with diameter of 500 ～700μ m Embosphere microspheres embolization of tumor feeding artery 2～4ml,under fluoroscopic observation blood lumen significantly slowed or stopped when vascular casting.Every month the liver enhanced CT or enhanced MRI examination follow ～up,check AFP and liver function,observation of clinical efficacy.Results all 50 cases treated by 2～5 improved significantly after treatment,follow-up of 5 ～36 months,of which 2 cases with tumors smaller than 5cm in patients after 3 ～4 treatment clinical symptoms disappeared,tumor clinical cure,normal AFP,more than 3 month evaluation of the efficacy of CR.In 29 cases after 2 ～5 treatment clinical symptoms,tumor size,AFP decreased significantly in the 20 ～500 μg\/L,more than 3 month evaluation of the efficacy of PR,17 patients with larger tumors,tumors showed no change after treatment,evaluation of the effect of NC,2 patients for tumor giant,with multiple intrahepatic metastases,after treatment of the tumor is still in effect,PD,efficiency(CR+PR) is 62%,the benefit rate(CP+PR+NC) 96%.Conclusion Embosphere microspheres as a novel embolic materials in primary hepatic artery embolization,clinical efficacy,safety,superior performance,is worthy of promotion and application of.