原发性肝癌合并脾亢的双介入治疗  

Dual intervention in therapy for primary hepatocarcinoma concurred with hypersplenism

作　　者：季学兵[1] 赵锡军[1] 吕维富[1] 张学彬[1] 

机构地区：[1]安徽省立医院介入放射科,合肥230001

出　　处：《中国肿瘤临床与康复》2002年第2期84-86,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　评价原发性肝癌合并脾亢行双介入治疗的疗效及其临床意义。方法　原发性肝癌合并脾亢患者 7例。均为男性 ,平均年龄 5 1岁 ,均有乙肝病史 15～ 2 0年 ,有肝硬化、脾肿大 ,6例为巨块型肝癌 ,1例为结节型 ,临床分期 :6例为Ⅱ期 ,1例为Ⅲ期 ;肝功能分级 :A级 4例 ,B级 3例 ;术前血小板计数为 :3 8± 14× 10 9/L ,伴白细胞减少 3例 :3 .6± 0 .1× 10 9/L ,红细胞减少 1例 :2 .73× 10 12 /L ,手术方式 :先行部分性脾栓塞 (PSE) ,然后行经导管肝动脉栓塞化疗术(THACE)。结果　术后 1～ 3天WBC :14 .2± 2 .8× 10 9/L ,BPC :5 3± 4× 10 9/L ;5～ 7天为 7± 1.7× 10 9/L ,10 3± 10×10 9/L ;术后第 14天 ,RBC为 :4.2 3× 10 12 /L(RBC减少者 )。术后一月复查CT :肝癌缩小约 3 0～ 40 % ,脾脏有所缩小 ,坏死区呈均匀坏死状态 ,肝功能有所改善。结论　双介入治疗原发性肝癌合并脾亢具有确切疗效 。Objective To evaluate the therapeutic effect and clinical significance of dual intervention in therapy for primary hepatocarcinoma concurred with hypersplenism.Methods 7 cases of primary hepatocaricinoma concurred with hypersplenism were males with an average age of 51 years.All of them had hepatitis B history of 15～20 years with cirrhosis and splenic enlargement.Six cases were of mass lump and one of nodular.Clinic stage:six were Ⅱ stage and one was Ⅲ stage.Liver function grade:four were A grade,three B grade.Preoperation,BPC was 38±14×10 9/L,three of them concurred with WBC decrease, being 3.6±0.1×10 9/L,one case concurred with RBC decrease, being 2.73×10 12 /L.First partial splenic embolization and then transcatheter hepatoarterial chemoembolization were operated on all of the cases.Results One to three days postoperation,WBC was 14.2±2.8×10 9/L,BPC was 53±4×10 9/L.Five to seven days postoperation,WBC was 7±1.7×10 9/L,BPC was 103±10×10 9/L.The amount of RBC which concurred with RBC decrease increased to 4.23×10 12 /L fourteen days postoperation.Reviewed CT one month postoperation showed:liver cancer reduced about 30 to 40 percent,spleen reduced partially and the necrotic area showed well distributed state.Liver function was improved.Conclusion Dual intervention in therapy for primary hepatocarcinoma concurred with hypersplenism has definite therapeutic effect and most important clinic significance.

关 键 词：原发性肝癌 脾亢 双介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]