植入放射性支架联合经动脉化疗栓塞(TACE)治疗肝恶性肿瘤合并下腔静脉(IVC)梗阻  

Implantation of irradiation stent combined with transarterial chemoembolization (TACE) for treatment of malignant inferior vena cava (IVC) obstruction caused by hepatic malignant tumor

作　　者：杨清慧[1] 张雯[1] 颜志平[1] 罗剑均[1] 刘凌晓[1] 杨敏捷[1] 刘清欣[1] 

机构地区：[1]复旦大学附属中山医院介入科,上海200032

出　　处：《复旦学报（医学版）》2014年第5期617-623,共7页Fudan University Journal of Medical Sciences

基　　金：上海市卫计委2013年度先进适宜技术推广项目(2013Y060)~~

摘　　要：目的探讨植入携带粒子条支架及经动脉化疗栓塞（transarterial chemoembolization,TAcE）联合治疗肝恶性肿瘤伴下腔静脉（inferior vena CaV＆，IvC）梗阻的安全性及疗效。方法对2008年7月至2013年6月共97例在我院接受介入治疗的肝恶性肿瘤伴下腔静脉梗阻患者的资料进行回顾性分析。在所有患者下腔静脉梗阻段植入携带粒子条支架，同时对肝内病灶进行化疗栓塞治疗。对下腔静脉症状缓解率、支架通畅性、生存期及预后因素进行分析。结果下腔静脉支架及粒子条植入手术成功率为100％；IVC支架通畅率为98％，下腔静脉梗阻症状缓解率为98％；患者平均生存时间为（277．6±251．4）天，中位生存期为（203．0±251．3）天；在随访期2～36个月期间支架通畅率为98％。结论植入携带粒子条支架联合经动脉化疗栓塞治疗肝恶性肿瘤伴下腔静脉梗阻患者安全可行，疗效好。Objective To investigate the safety and efficacy of implantation of self-expanding metal stent loaded with ^125I seeds strands combined with transarterial chemoembolization （TACE） for treatment of patients with malignant inferior vena cava （IVC） obstruction caused by hepatic malignant tumor. Methods From July 2008 to June 2013, the data of 97 patients with malignant IVC obstruction caused by hepatic malignant tumor were retrospectively analyzed. Self-expanding metal stent loaded with ^125Iseeds strands was implanted in the obstructive segment of IVC and hepatic lesion was treated by TACE in all patients. The relief rate of symptom related to IVC obstruction, stent patency,overall survival and prognostic factors were analyzed. Results The technical success rate of irradiation stent implantation was 100%. The patency rate of IVC stents was 98%. The relief rate of syndrome related to IVC obstruction was 98%. During a range of 2 - 36 months follow-up, the mean and median survival time were （277.6±251.4） days and （203.0 ± 251.3） days,respectively. During the 2 - 36 Months＇ follow-up, the patencv rate of IVC stents was 98%.

关 键 词：^125I粒子 肝细胞肝癌 下腔静脉 近距离放疗 经动脉化疗栓塞(TACE) 

分 类 号：R735.7[医药卫生—肿瘤]