手术切除联合术中^125I植入治疗36例深部小肝癌疗效分析  

作　　者：许世江[1] 郑书伟[1] 余发全[1] 

机构地区：[1]解放军第十二医院外一科,新疆疏勒县844200

出　　处：《浙江临床医学》2014年第1期4-5,共2页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨深部小肝癌的诊断及治疗经验。方法回顾分析2009年5月至2013年4月诊治的36例深部小肝癌患者的临床资料。结果深部小肝癌术前确诊率低，术中定位困难，易残留，如行广泛切除，病死率及肝功能衰竭发生率高。结论（1）超声引导下肝穿刺活检很大程度上提高了深部小肝癌术前诊断阳性率。（2）术前超声引导下经皮肝穿刺美蓝定位，使术中病变定位准确，可减少肝组织损伤及出血量，缩短手术时间，降低术后发生肝功能衰竭的风险。（3）在美蓝定位基础上，行不规则肝部分切除术，病变切除彻底，且在切除病灶基础上使更多的肝组织得以保留，进一步降低术后病死率及肝功能衰竭发生率，实用价值很高。（4）术中对肿瘤切除创面进行^125I放射性粒子植入，能进一步提高深部小肝癌治疗效果。Objective To explore the diagnosis and treatment of deep minute hepatocellular carcinoma（HCC）. Method 36 cases of deep minute hepatocellular carcinoma treated in 12th hospital（from May,2009 to April,2013）were retrospectively reviewed. Result Deep minute hepatocellular carcinoma is difficult to diagnosed and located in early period. Furthermore,extensive resection leads to high risk of mortality or liver failure. Conclusion （1）Percutaneous transhepatic cholangiography（PTC）guided by ultrasonography is helpful to the accuracy of diagnosing.（2）Coeruleum methylenum PTC can locate tumor accurately and shorten operation time and reduce liver injury and risk of liver failure.（3）On the base of Coeruleum methylenum PTC irregular liver resection can preserve more tissue and reduce postoperative mortality and possibility of liver failure.（4）The ^125I radioactive seeds implanted in patients can further improve the therapeutic effect of subclinical hepatocellular carcinoma.

关 键 词：深部小肝癌 ^125I放射性粒入植入 治疗 

分 类 号：R73-35[医药卫生—肿瘤]