原发性肝癌合并门静脉癌栓术后化疗途径和给药方式的临床研究  

The Clinical Study of Postoperative Chemotherapy and Administration Pathways in Primary Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus

作　　者：王永忠[1] 魏秀吾[1] 徐书楷[1] 谢召平[1] 

机构地区：[1]福建省三明市第二医院外科,福建三明366000

出　　处：《中国医师杂志》2005年第6期730-732,共3页Journal of Chinese Physician

基　　金：福建省卫生厅青年科研基金(2002-1-30)

摘　　要：目的本文探讨四组原发性肝癌(PHC)合并门静脉癌栓(PVTT)术后不同化疗途径和给药方式对患者疗效的影响。方法60例PHC合并PVTT病人随机分成4组,A组行经导管化疗栓塞(TACE)治疗;B组行TACE+门静脉置化疗(PVI),且PVI采用快速推注给药;C组行TACE+PVI,且PVI采用电脑控制的微量泵缓慢灌注给药;D组行肝动脉置管化疗栓塞(HAI)+PVI,且PVI采用电脑控制的缓慢灌注给药。结果A、B、C三组间生存率分别有显著性差别(P<0.05),C组疗效较好;C、D两组间生存率差别无显著意义(P>0.05)。结论PLC合并PVTT患者术后宜采用肝动脉门静脉双途径化疗且门静脉宜用持续灌注化疗,而经肝动脉行TACE或HAL均可。Objective To explore the therapeutic effect of different postoperative chemotherapy and administration pathways in primary hepatocellular carcinoma (PHC) patients with portal vein tumor thrombus (PVTT). Methods 60 PHC patients with PVTT were divided into A, B, C and D groups. A group was treated by transcatheter arterial chemo-embolization (TACE); B group was treated by TACE and portal vein intubation(PVI) with quick intravenous injection; C group was treated by TACE and PVI with slow infusion controlled by computer; and D group was treated by hepatic arterial intubation chemo-embolization (HAI) and PVI with slow infusion controlled by computer. Results The survival rate among groups A, B and C had a significant difference (P<0.05), group C had the best efficacy, and the survival rate between groups C and D had not a significant difference (P>0.05). Conclusion PHC patients with PVTT could be treated by both hepatic arterial chemotherapy and portal vein chemotherapy throug portal vein continuous infusion. TACE or HAI was suitable for postoperative chemotherapy.

关 键 词：门静脉癌栓 原发性肝癌 给药方式 化疗途径 临床研究 术后 肝动脉置管化疗栓塞 经导管化疗栓塞 静脉双途径化疗 持续灌注化疗 PVTT 灌注给药 电脑控制 PVI TACE 经肝动脉 生存率 PHC 微量泵 性差别 PLC HAL 疗效 患者 C组 

分 类 号：R735.7[医药卫生—肿瘤] R979.1[医药卫生—临床医学]