乙酸化学消融联合肝动脉化疗栓塞治疗肝脏恶性肿瘤  

CT fluoroscopic guidance percutaneous acetic acid injection tumor ablation and TACE for the malignant liver tumor

作　　者：张琳[1] 牟玮[1] 王健[1] 朱结辉[1] 刘凤秀[1] 胡春芳[1] 李中会[1] 黄学全[1] 

机构地区：[1]第三军医大学西南医院放射科,重庆400038

出　　处：《介入放射学杂志》2007年第12期831-833,共3页Journal of Interventional Radiology

摘　　要：目的评价CT透视引导经皮穿刺乙酸注射(PAI)联合肝动脉化疗栓塞治疗肝脏恶性肿瘤的安全性和疗效。方法收集我院2005年5月至2007年6月在实时CT透视导向下PAI治疗肝动脉化疗栓塞术后复发肝脏恶性肿瘤78例,其中肝细胞癌70例、转移性腺癌8例。根据病灶大小每次注入50%～60%7乙酸2～10ml,乙酸内加入1ml对比剂混匀,以了解乙酸在肿块内的弥散程度和范围。注射后1周影像检查,根据情况重复注射1～2次。结果在实时CT透视下均能准确穿刺到靶点。注入后42例出现轻中度疼痛,无其他并发症。全部病例均经CT随访,3个月时,其中瘤灶缩小32例(41%),肿瘤大小无变化38例(49%),肿瘤增大8例(10%)。78例3个月随访,全部生存;48例随访1年,40例生存,8例失访。结论CT透视引导下经皮乙酸消融联合肝动脉化疗栓塞治疗肝脏恶性肿瘤安全、有效。Objective To evaluate the safety and efficacy of CT fluoroscopic guidance percutaneous acetic acid injection （PAI）tumor ablation and TACE for the malignant liver tumor. Methods PAI had been performed after TACE on 78 patients with malignant tumor （hepatocellular carcinoma 70, metastatic adenecarcinoma 8） since May 2005 to June 2007 in Southwest Hospital. All procedures were performed under CT fluoroscopic guidance. According to the different size of lesions, 50% - 60% acetic acid 2 - 10 rnl was injected into the lesions. PAI was repeated once or twice in some lesions based on the imaging. Results The needle could reach targets under CT real time fluoroscopy in all patients. No complication occurred, but with only moderate pain in 42 cases. The size of tumors shrank in 32 cases, remained unchanged 38 cases, and increased in 8 cases. The efficiency was 90%. All 78 patients were followed up for 3 months with all survival and 48 patients for 1 year with 40 survival. Conclusions CT fluoroscopic guidance PAI tumor ablation combined with TACE in the treatment of malignant liver tumor is safe and effective.

关 键 词：肝脏肿瘤 CT透视 乙酸 经动脉化疗栓塞 消融 

分 类 号：R735.7[医药卫生—肿瘤]