无水乙醇在巨块型肝癌经皮动脉栓塞术中的价值及临床疗效观察  

The Clinical Value and Efficacy of Transcatheter Arterial Embolization of Huge Primary Hepatocellular Carcinoma with Ethanol

作　　者：罗小平[1] 淦伟[1] 

机构地区：[1]重庆医科大学第二医院介入治疗中心,400010

出　　处：《临床放射学杂志》2008年第1期89-92,共4页Journal of Clinical Radiology

摘　　要：目的评价无水乙醇在巨块型肝癌经皮肝动脉栓塞术中的临床疗效及不良反应，探讨该疗法的操作技术要领与其临床价值。资料与方法结合CT、MRI等影像资料，在X线机引导下，对165例巨块型肝癌以无水乙醇＋等量超液态碘油实施肿瘤滋养动脉（包括肝动脉及其侧支供瘤动脉）超选择性完全性充填栓塞，直至碘油充填影像与CT、MRI等影像资料完全相符。结果165例肝癌肿块经一次栓塞后95％以上被固化乃至完全固化135例（81．8％），大部固化30例（18．2％）；经2—3次栓塞治疗后，95％以上被固化乃至完全固化159例（96．4％），大部固化6例（3．6％）。3—6个月复查肿块明显缩小151例（91．5％），部分缩小14例（8．5％）。术后1周患者肝功能无明显改变131例（79．4％），肝功能轻度变差24例（14．5％），肝功能明显变差10例（6．1％）。术后6个月生存165例（100％），6个月-1年生存126例（76．4％），1—2年生存91例（55．1％），2—3年生存69例（41．8％），3年以上生存49例（29．7％）。结论无水乙醇＋等量超液态碘油超选择性肿瘤滋养动脉插管并完全性充填栓塞，可以迅速和较为彻底地杀灭局部肿瘤组织，避免了肿瘤的扩展、浸润生长及转移的发生，同时避免了化疗药物对肝细胞的损害及对全身的毒副反应，能有效提高患者的生活质量，明显延长患者的生存期。只要操作得当，是较为安全的介入治疗方法。Objective To evaluate the efficacy and side effect of transcatheter arterial embolization of huge primary hepatocellular carcinoma with ethanol. Materials and Methods Superselective transcatheter arterial embolization of 165 cases with huge primary hepatocellular carcinoma was performed with ethanol plus equal amount of lipiodol under the guidance of X-ray. Results With one time embolization, 95 - 100% solidification was found in 81.8% of patients（ 135/165 ）, greater part of solidification was found in 18.2% of patients（30/165 ） ; with 2 -3 times embolization, 95 - 100% solidification was found in 96.4% of patients（ 159/165 ） , greater part of solidification was found in 4% of patients （6/165）. On reexamination 3 -6 months later, obvious shrink on the size of tumor was found in 92% of patients（ 151/165）, the partial shrink in 8.5% （14/165）. On the postoperative I week, no obvious damage of liver function was found in 79.4% （ 131/165）, slight abnormal was found in 14.5% （24/165）, obvious damage in 6% （ 10/ 165）. The survival rates were 100% for6 months, 76.4% for 0.5 -1 year, 55.1% for 1 -2 years, 41.8% for2 -3 years, 29.7% for 3 year or more. Conclusion Superselective transcatheter arterial embolization of tumor with full filling of ethanol plus equal amount lipiodol can kill tumor tissue, and avoid to develop spread, infiltration and metastasis of tumor, and also avoid to develop damage of hepatocellular and side effect of anticancer drugs, which can effectively improve the quality of patient＇s life, and obviously prolong survival time.

关 键 词：无水乙醇 巨块型肝癌 栓塞 

分 类 号：R735.7[医药卫生—肿瘤]