动脉插管化疗药物灌注治疗晚期肝癌伴肝功能不全的临床观察  

Clinical observation of arterial perfusion chemotherapy in the treatment of late-satge liver cancer associated with hepatic insufficiency

作　　者：茅爱武[1] 胡璇[1] 李国芬[1] 刘诗义[1] 方世明[1] 林青[1] 高中度[1] 

机构地区：[1]上海市长宁区同仁医院介入中心,200050

出　　处：《介入放射学杂志》2007年第11期772-775,共4页Journal of Interventional Radiology

基　　金：上海市科学发展研究基金

摘　　要：目的应用介入化疗高效、低毒的特性,探索为伴肝功能不全的晚期肝癌患者提供治疗机会的方法。方法对120例伴肝功能不全的晚期肝癌患者按照TBIL、BIL、ALT等肝功能数据以及腹胀、腹痛、纳差、少尿等临床症状表现,采用个体化、小剂量供血动脉插管化疗药物灌注治疗。观察治疗前后患者肝功能及一般状况的变化。结果术后1周复查,97例(80.8%)患者TBIL、BIL、ALT短暂升高,23例(19.2%)患者肝功能无明显变化。术后3周复查,86例(71.7%)患者TBIL下降50%以上,32例(26.7%)患者下降30%,ALT较治疗前无明显变化或有所下降。112例(93.3%)患者临床症状不同程度缓解,KPS评分由原10～40分(中位20分)提高到20～60分(中位40分)。结论对于已伴有肝功能不全的晚期重症肝癌患者,果断把握治疗时机、严格掌控操作技术,采用小剂量动脉灌注化疗,同样可以起到抑制肿瘤、缓解症状,延长生存时间的积极作用。Objective To probe the possible methods in the treatment of late-stage liver cancer associated with hepatic insufficiency through high-efficiency and low-toxity interventional chemotherapy. Methods 120 cases of late-stage liver cancer patients with hepatic insuffiency were given small dosages of chemotherapy through arterial perfusion individually accordingly to the liver functions of TBIL, BIL, ALT and clinical manifestations such as turbulence, abdorminal distension, pain and oliguresis. The observation of the changes for the liver function and general condition was undertaken before and after the therapy. Results 97 cases had transient increae of TBIL, BIL and ALT one week after perfusion, other cases showed no apparent change. But three weeks later, TBIL decreased 50% in 86 cases, 30% in 27 cases. ALT had no change or even decrease 30% in some patients. 112（93.3%）cases had relief in symptoms of turbulence, inappetence and oliguresis. KPS raised to 20 ～ 60（median 40）from primary 10 ～40（median 20）. Conclusion Arterial perfusion chemotherapy with small dosage can also control tumor growth, relief pain, improving life quality and prolongation of life span in treating late-stage liver cancer with hepatic insufficiency skillfully and promptly.

关 键 词：晚期肝癌 肝功能不全 介入化疗 

分 类 号：R735.7[医药卫生—肿瘤]