超声引导无水乙醇量化治疗特殊部位原发性肝癌  

Ultrasound-guided Percutaneous Quantified Absolute Ethanol Injection for Treatment of Hepatic Carcinoma in Special Parts

作　　者：杨嘉嘉[1] 林礼务[1] 薛恩生[1] 何以敉[1] 高上达[1] 俞丽云[1] 

机构地区：[1]福建医科大学附属协和医院超声科,福州市350001

出　　处：《中国超声医学杂志》2010年第12期1098-1101,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价超声引导无水乙醇量化治疗特殊部位肝癌的临床疗效及应用价值。方法超声引导无水乙醇量化治疗特殊部位(大血管旁或肝脏周缘)肝癌42例,其中位于近第二肝门处6例,左外叶上段近心脏处5例。治疗后密切随访,对复发病例再行量化治疗。统计1、2、3年总生存率、原位复发生存率及无瘤生存率。结果 42例患者1、2、3年总生存率为96.1%、86.5%、77.2%;无原位复发生存率为87.4%、79.6%、71.5%;无瘤生存率为72.1%、60.2%、49.6%。35例治疗后行超声造影仅5例可见原病灶小片区域低增强,再次行量化治疗1个月后复查未见增强。治疗后AFP转阴率(降至20 ng/ml以下)达78.9%(30/38)。所有病例均未见大出血等严重并发症。结论超声引导无水乙醇量化治疗特殊部位肝癌能够取得较为理想的生存率,疗效显著;配备规范的术中监测及术后随访机制,对提高整体治疗效果具有极其重要的作用。Objective To evaluate quantified therapy of primary hepatic carcinoma in special parts by percutaneous absolute ethanol injection（PQEI）guided with ultrasound. Methods The tumors located next to large vessels or liver edge in 42 cases were treated with PQEI. There were f; cases located near the secondary liver porta and 5 cases near the heart in the upper segment of left lateral lobe. Close follow-up was conducted. Re treatment of PQEI was taken for recurrent cases. The rates of overall survival, in situ recurrence-free survival and diseasefree survival of 1, 2,3 years were calculated. Results The overall survival rates of 1,2,3 years in 42 cases were 96. 1 %, 86.5 %, 77.2 %. In situ re currence-free survival rates were 87.4%,79.6 %,71.5 % and disease-free survival rates were 72.1%,60.2%,49.6%. Results of ultrasound contrast examination after PQEI in 35 cases showed that slight enhancement in several sites were found in 5 tumors and no enhancement1 month after one repeated PQEI. AFP became negative after PQEI in 78.9 % （30/38）cases. No severe complications were found in all cases. Conclusions PQEI has significant effects in improving the survival rate of patients with hepatic carcinoma in special parts,moreover, standard intraoperative monitoring and postoperative follow-up plays an important role in improving overall treatment effect.

关 键 词：肝癌 超声引导 无水乙醇 治疗 

分 类 号：R735.7[医药卫生—肿瘤]