小肝癌合并严重肝硬化的肝动脉和门静脉途径中西医结合介入治疗  

Multiple interventional radiological treatments combining with Chinese and western medicines for patients with small hepatocellular carcinoma complicated by severe liver cirrhosis

作　　者：谢宗贵[1] 周大桥[1] 张海生[1] 王小珍[1] 胡元明[1] 黄云龙[1] 

机构地区：[1]深圳市中医院广州中医药大学深圳附属医院影像科,广东省深圳518033

出　　处：《中国基层医药》2006年第2期270-272,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省深圳市科技局资助项目(JH200505260267A)

摘　　要：目的探讨肝动脉低剂量中西化疗药物肿瘤血管热灌注及栓塞治疗和门静脉中西护肝药物灌注治疗相结合对小肝癌合并严重肝硬化患者的疗效。方法小肝癌合并严重肝硬化患者9例,采用以榄香烯为主的节段性肝动脉热灌注化疗和栓塞治疗小肝癌;采用经皮经肝穿刺门静脉行食管胃底静脉栓塞和导管-药盒系统植入术,并经导管-药盒系统行复方丹参注射液等中西护肝药物门静脉区域性灌注治疗。结果9例患者小肝癌瘤灶得到较好控制,AFP水平下降;食管胃底静脉栓塞和导管-药盒系统植入操作成功;门静脉区域性中西护肝药物灌注治疗后门静脉压力下降(12±3.5)cmH2O,肝功能显著改善。结论肝动脉和门静脉途径中西医结合介入治疗可作为小肝癌合并严重肝硬化有效的姑息性方法。Objeetive To evaluate effects of the combination of segmental hepatic arteries hot drug infusion/ chemo-embolization and portal vein infusion with Chinese and western medicines for patients with small hepatocellular carcinoma complicated by severe liver cirrhosis. Methods Nine patients with small hepatocellular carcinoma complicated by severe liver cirrhosis were included in this study. All of them adopted four types of interventional procedures：segmental hepatic arteries hot drug infusion/chemo-embolization dominating with elemene emulsion, percutaneous transhepatic esophago-gastric vafices embolization, portal vein port-catheter system implantation and portal vein infusion dominating with the compound salvia miltiorhiza injection. Results The nodes of small hepatocellular carcinoma were controlled and AFP level declined after anti-cancer treatment. The procedures of esophago-gastric varices embolization and： portal vein port-catheter system implantation obtained success. Pressure of portal vein declined （ 12 ±3.5 ）cmH2O and liver function improved significantly after directly portal vein medicines infusion therapy. Conclusion The combination of interventional radiological methods via the routines of segmental hepatic arteries and portal vein with Chinese and western medicines is an effective option for patients with small hepatocellular carcinoma complicated by severe liver cirrhosis.

关 键 词：肝肿瘤 治疗性栓塞 导管-药盒系统 肝动脉途径 门静脉途径 严重肝硬化 中西医结合介入治疗 

分 类 号：R735.7[医药卫生—肿瘤] R575.2[医药卫生—临床医学]