双介入法治疗肝癌门静脉癌栓  

Treatment of Liver Cancer with Portal Vein Tumor Thrombus with TACE plus Percutaneous Portal Vein Injection of Ethanol Combined Lipiodol

作　　者：郭旻[1] 肖金成[1] 赵晶[2] 

机构地区：[1]河南省肿瘤医院放射科,郑州市450008 [2]山东大学威海分校医院,威海市264209

出　　处：《医药论坛杂志》2006年第21期8-9,共2页Journal of Medical Forum

摘　　要：目的探讨双介入法治疗肝癌门静脉癌栓的疗效。方法对25例不能手术的肝癌并门静脉癌栓的患者于TACE治疗5～7d后，在CT引导下经皮门静脉穿刺向癌栓内注射无水酒精碘化油乳液。结果25例中PVTT消失率24％（6／25），缩小率48％（12／25），有效率72％（18／25）。肿瘤缩小率88％（22／25）。AFP转阴率80％。治疗后门脉情况发生明显改善：DSA间接门静脉造影见门静脉延迟显现时间明显缩短、门脉主干或分支充盈缺损减小或消失，与治疗前比较有明显差异（P〈0．05）。患者1、2、3年生存率76％（19／25）、40％（10／25）、24％（6／25）。结论TACE联合经皮门静脉穿刺注射无水酒精碘化油乳液治疗肝癌门静脉主干癌栓可降低患者门静脉压力，预防肝内转移，提高疗效，改善生存质量，延长生存期。Objective To study the effect of treatment with transcatheter artery chemoembolization（TACE） plus percutaneous portal vein injection of ethanol combined lipiodol on liver cancer with portal vein tumor thrombus（PVTF）. Methods 25 cases liver cancer patients were treated by injection of ethanol combined lipiodol into liver cancer with portal vein tumor thrombus after 5 - 7 days of TACE. Results The rates of PVTT disappearance and shrinkage were 24% （6/25） and 48% （12/25） respectively. The tumor mass shrinkage rates was 88% （22/25） and AFP negative reversion rates was 80%. The emergence time of portal vein was put off after treatment. Two groups of cases is apparently different before and after treatment （P 〈 0.05 ）. The 1,2 and 3 year survival rates for combined interventional therapy were 76% （ 19/25 ） ,40% （ 10/25 ） and 24% （6/25）. Conclusion Combined interventional therapy is a very effective way for liver cancer with portal vein tumor thrombus.

关 键 词：肝癌 门静脉主干癌栓 经皮肝动脉化学栓塞术 无水酒精碘化油乳液注射术 

分 类 号：R735.7[医药卫生—肿瘤]