肝癌门静脉癌栓的经皮激光消融治疗

Treatment of portal vein tumor thrombus of hepatocellular carcinoma with percutaneous laser ablation

目的 介绍肝癌门静脉癌栓激光消融治疗的方法 ,并探讨这一治疗方法的安全性和疗效。方法 对 2 4例肝癌门静脉癌栓患者 30支门静脉癌栓进行经皮肝穿刺激光消融治疗 ,观察术后患者癌栓支门静脉多普勒彩色血流图谱的变化及临床症状、肝功能和腹水等的变化情况。结果 术前 30支门静脉癌栓支均无血流信号 ,术后 1d有 2 8支门静脉再次观察到彩色血流信号 ;术后 7d 30支门静脉癌栓支均观察到了多普勒彩色血流信号 ;术后 30d有 12支可观察到连续但不稳定的彩色血流信号 ,16支可观察到连续且稳定的再通血流信号 ;术后 90d有 18支可观察到连续且稳定的再通血流信号。临床症状、肝功能和腹水均得到了不同程度的改善。结论 肝癌门静脉癌栓的激光消融治疗有望成为一种疗效可靠、技术安全的门静脉癌栓治疗新方法。

ObjectiveTo introduce a newly developed procedure in the control of portal vein tumor thrombus (PVTT) of hepatocellular carcinoma (HCC),and evaluate the efficacy and indicate of this method. MethodsThe PVTT of HCC patients were treated by percutaneous transhepatic laser ablation (LA).The blood flow of PVTT embolized portal vein,live function,ascites and clinical presentation was observed. ResultsTwenty-four HCC patients,with a total of 30 PVTT portal vein and its main branch were treated with LA.There were no any blood flow signal in Doppler color Utrasonagraphy in these PVTT embolized portal vein before treatment. After treatment,blood flow was reappearance in all cases within one week.The continued patendy blood flow was observed in 16 portal vein and continued but not patendy blood flow in other 12 portal vein within 30 days.The continued patendy blood flow was observed in 18 portal vein within 90 days.The improvement of liver function and clinical symptom.The reduction of ascites was observed in varying degrees. ConclusionLA treatment might be a effective and safe procedure in the control of portal vein tumor thrombus of HCC.