肺动脉化疗药盒埋置术治疗肝癌肺转移  

Implantation port-catheter permanent indwelling of pulmonary artery in treating lung metastasis from HCC

作　　者：程洁敏[1] 王建华[1] 颜志平[1] 王小林[1] 龚高全[1] 刘清欣[1] 

机构地区：[1]上海医科大学中山医院放射科,200032

出　　处：《介入放射学杂志》2000年第3期158-160,共3页Journal of Interventional Radiology

基　　金：国家"九五"攻关项目课题 !批准号:96-907-03-01

摘　　要：目的　研究肺动脉化疗导管药盒埋置术治疗原发性肝癌肺转移的疗效。方法　原发性肝癌肺转移病例 6 2例 ,其中一侧肺转移者 19例 ,两侧肺转移者 43例。除常规肝动脉化疗栓塞治疗外 ,加作经锁骨下静脉穿刺肺动脉化疗导管药盒埋置术。一侧肺转移病灶者 ,导管头端埋于患侧肺动脉内 ;两侧转移灶者 ,导管头端埋于肺总动脉处。化疗方案为FDM或FDA。如果肝癌控制良好 ,则在药盒内每月注入化疗药物 1次。结果　肺动脉化疗药盒埋置术的技术成功率为 10 0 % ,并发症主要为感染 ( 3.2 % ) ,创口不愈合 ( 1.6 % ) ,气胸 ( 3.2 % )。疗效 :3个月随访 ,肺部病灶明显缩小占 35 .5 % ;无变化 (SD)占 32 .3% ;增大 (PD)占 32 .3 %。 6个月随访 ,12例死于肺外病变 ,余均健在。PR占 2 2 .6 % ;SD占 2 5 .8% ;PD占 32 .3 %。结论　肺动脉化疗药盒埋置术操作简单 ,并发症少 ,疗效确切 。Objective To observe the efficacy of a percutaneous implantation portcatheter permanent indwelling pulmonary artery for regional chemotherapy of the metastatic lung cancer from HCC. Methods Between 1995 and 1999, 62 patients (42 males, 20 females; mean age 46 years) suffering from the metastatic lung cancer from HCC underwent percutaneous implantation of portcatheter permanent indwelling pulmonary artery using the right subclavian vein. In 19 patients with metastatic tumor located on one side of the lung, an indwelling catheter was placed into the ipsilateral side pulmonary artery. With metastasis of both sides, the catheter was inserted into the main trunk of pulmonary artery. The regimens of the chemotherapy were 5-FU+CDDP+MMC(FDM) or 5-FU+CDDP+MMC(FDA). Results The interventional procedure was successfully completed in all 62 cases (100%). The complications occurred in 8% cases, including infections(3.2%), unhealed wound (1.6%) and pneumothorax (3.2%). The treatment effects of 3months after the procedure were as follows: the obvious decrease of lung tumor size was 35.5%; stable disease (SD) 32.3% and progressive disease (PD) 32.3%. 6 months followup: 12 patients were dead (12/62) and the others are still doing well. The response rates were 22.6%, partial response (PR) 32.3%; stable disease (SD) 25.8% and progressive disease (PD) 32.3%.Conclusions The percutaneous implantation techniques of pulmonary arterial portcatheter could be a good method in the treatment of metastatic lung cancer from HCC because of it's simple, with few complications and positive effects.

关 键 词：化疗 导管 化疗药盒 肝癌肺转移 治疗 

分 类 号：R735.7[医药卫生—肿瘤]