介入治疗在肝细胞癌伴肝动脉-门静脉分流患者中的应用  

Application of interventional therapy on hepatocellular carcinoma with hepatic arterioportal shunts

作　　者：孙顺吉[1] 郝刚[2] 赵凯[1] 王帅[1] 冯学强[1] 王鹏[1] 王秀春[1] 

机构地区：[1]潍坊医学院附属医院血管介入科,261031 [2]山东省潍坊市人民医院介入放射科

出　　处：《中国医师进修杂志》2011年第26期30-32,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察介入栓塞治疗肝细胞癌伴肝动脉-门静脉分流（APS）的临床疗效，以期提高患者的生存质量和生存期。方法选择诊断明确的29例肝细胞癌伴APS患者，聚乙烯醇（PVA）颗粒、钢圈栓塞后常规行介入化疗栓塞术（TACE）治疗，观察临床症状的改善情况及不良反应的处理及患者的生存率。结果29例患者中19例1次栓塞Alas闭塞[成功率65．5％（19／29）]；3例栓塞后APS重新开通[开通率10．3％（3／29）]，经再次栓塞后消失；7例出现新的Alas[发生率24．1％（7/29），其中5例栓塞2次、2例栓塞3次]。术后患者消化道出血、腹泻、腹水的有效率分别为91．7％（11／12）、84．6％（11／13）、83．3％（15／18）。随访1个月至2年，3个月、6个月、1年和2年生存率分别为96．6％（28／29）、89．7％（26／29）、65．5％（19，29）和34．5％（10／29）。结论介入治疗伴Alas的肝细胞癌患者临床上是安全有效的。Objective To observe the clinical effect of interventional embohzation on hepatocellular carcinoma （HCC） with hepatic arterioportal shunts （APS） ,in the hope of improving patients＇ survival quality and time. Methods Twenty-nine patients with HCC patients and APS after a successful PYA, steel coils embolization,all patients were given routine TACE therapy. The changes of gastrointestinal bleeding, ascites,diarrhea and aminotransferase were analyzed retrospectively. Results Nineteen cases got successful embolization in the first time [achievement ratio 65.5% （19/29）]; 3 cases got recurrence after embolization [patency ratio 10.3% （3/29）],7 cases appeared new APS [incidence ratio 24.1% （7/29）,5 cases were embolized 2 times, 2 cases were embolized 3 times ]. The effective rate of gastrointestinal bleeding, diarrhoea, ascites were 91.7% （11/12）, 84.6% （ 11/13 ）, 83.3% （ 15/18 ） respectively, which had significant difference between preoperative and postoperative condition. The survival rate of 3 months,6 months, 1 year,and 2 years after operation were 96.6% （28/29）,89.7% （26/29）,65.5% （19/29）,34.5% （10/29）. Conclusion Interventional therapy is a safe and effective treatment to HCC with APS.

关 键 词：肝肿瘤 动脉-门静脉分流 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]