经皮穿刺瘤内注射碘油化疗药乳剂在外生型肝癌介入治疗中的应用  

Percutaneous chemotherapic agents lipiodol emulsion injection for the treatment of pedunculated hepatocellular carcinoma

作　　者：张儒焱[1] 陈勇[1] 曾庆乐[1] 赵剑波[1] 刘战胜[1] 李彦豪[1] 

机构地区：[1]南方医科大学附属南方医院介入治疗科,广东510515

出　　处：《当代医学》2009年第29期547-549,共3页Contemporary Medicine

摘　　要：目的探讨经皮穿刺瘤内注入碘油化疗药乳剂(CALE)在外生型肝癌介入中的价值。方法外生型肝癌患者24例,男19例,女5例。年龄21～67岁,平均49岁。术前常规行动脉造影显示不适合经动脉途径给药,且透视或CT显示瘤周或瘤内CALE存积欠佳。在透视或者CT引导下,经皮穿刺到靶区后,注入CALE。术后定期复查AFP和上腹部CT。结果24例患者,共经皮穿刺瘤内注药61次,平均每例2.54次。均穿刺和注药成功,技术成功率为100%。AFP阳性的22例,治疗后14例降到正常范围,占63.6%。术后1月CT显示CALE在靶区沉积良好者18例次(81.2%),欠佳者6例次(18.8%)。随访2月～5年,平均2.2年。患者中位生存时间425天。随访期间,未见严重并发症。结论经皮瘤内注射碘油化疗乳剂治疗外生型肝癌是有效和安全的,可作为经动脉途径的补充,以提高外生型肝癌介入治疗的疗效。Objective To value the effect of percutaneous CALE injection in the treatment of pedunculated hepatocellular carcinoma（P-HCC）. Method 24 P-HCC patients （19 male and 5 female） were included, with average age of 49y （21- 67y）. By arteriography, lack of blood supply in target areas was showed. CALE injection was carried out under fluoroscopy or CT guidance. Serum AFP and epigastric CT were followed up periodically.Results 24 patients received 61 times procedures with the average 2.54 times per patient, with 100% technique success rate. Serum AFP was positive in 22 patients and decreased to normal after one session or more of treatment in 14 patients （63.6%）. 18 lesions （81.2%） were found with well distribution of the lipiodol-cbemotherapy mixture on CT scan obtained 1 month after procedure, Follow-up ranged 2 months to five years （mean, 2.2 years）. The median survival time was 425d. No complications were observed during the period of follow-up. Conclusions percutaneous CALE injection is effective and safe, and it can be used as a effective supplement to TACE in treating pedunculated hepatocellular carcinoma.

关 键 词：外生型肝癌 消融 肝动脉栓塞 碘油化疗乳剂 

分 类 号：R735.7[医药卫生—肿瘤]