双介入疗法治疗巨大坏死性肝转移瘤的应用  

Clinical application of combined interventional therapy for large necrotic metastasis of liver

作　　者：郝刚[1] 孔铭新[1] 李伟[1] 坚永彬[1] 

机构地区：[1]山东省潍坊市人民医院介入放射科,山东潍坊261041

出　　处：《中国介入影像与治疗学》2006年第3期211-213,共3页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨肝动脉化疗栓塞(TACE)+CT引导下穿刺置管引流、无水乙醇注射治疗巨大坏死性肝转移瘤(LNML)的应用。方法9例LNML患者,瘤体直径7～21cm,平均15cm,全部患者均已行原发病灶切除。原发病包括胃间质恶性肿瘤1例,结肠腺癌4例,直肠癌3例,肺癌1例。肝内肿瘤在行肝动脉化疗栓塞术3～5天内,于CT导向下经皮穿刺置管引流坏死物并无水乙醇注射。结果术后9例患者的临床症状均明显缓解,术后1周复查CT显示瘤腔明显减小。随访结果:患者的2年生存率为66.7%。结论肝动脉化疗栓塞结合CT引导下置管引流、无水乙醇注射是治疗LNML的有效双介入方法。Objective To study the therapeutic effectiveness of combined treatment with transcatheter arterial chemoembolization （TACE） and CT-guided percutaneous catheter drainage of tumor necrosis with absolute ethanol injection for the patients of large necrotic metastasis of liver （LNML）. Methods Nine patients with large LNML 7 - 21 cm in diameter （mean diameter 15 cm）, had already resected the primary lesions, one from malignant mesenchymoma of stomach, four from adenocarcinoma of colon, three from carcinoma of rectum and one from lung cancer. CT-guided percutaneous catheter drainage of tumor necrosis with absolute ethanol injection was performed after TACE. Results No major complications occurred in all 9 patients, only 4 patients had local pain. CT scan showed the volume of tumor was decrease significantly and lipiodol deposited well. The clinical syndromes of all patients remissioned. Survival time of 1-1.5 year was 3 patients, excelled 2 year was 6 patients. Conclusion TACE followed by CT-guided percutaneous catheter drainage of tumor necrosis with absolute ethanol injection is a safe and effective therapeutic method for treating LNML.

关 键 词：肿瘤转移 抽吸 放射学 介入性 经皮导管引流 栓塞 无水乙醇 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]