门静脉支架同步^(125)I粒子条植入联合经导管动脉化疗栓塞术治疗肝癌伴门静脉癌栓  

Portal vein stenting combined with linear ^(125)I seed strand implantation and TACE for treatment of hepatocellular carcinoma with portal vein tumor thrombus

作　　者：单长胜[1] 王松[1] 于春鹏[1] 谭好飞 李舰[1] 李健[1] 李子祥[1] 孙成建[1] 

机构地区：[1]青岛大学附属医院介入医学科,山东青岛266000

出　　处：《中国医学影像技术》2015年第3期429-433,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨门静脉支架同步125I粒子条植入联合TACE治疗肝癌伴门静脉癌栓的临床效果。方法对15例肝癌伴门静脉癌栓患者先行经皮肝穿刺门静脉支架同步125I粒子条植入术,再行TACE治疗,随访并计算其累积生存率和支架通畅率。结果对所有患者均成功植入门静脉支架及125I粒子条,未出现穿刺道出血、胆汁瘘及急性肝肾衰减等严重并发症。对全部患者共行38次TACE治疗。术后随访6~12个月,3例存活,12例死亡,其中4例死于消化道出血,2例死于肺转移,6例死于肿瘤进展致肝衰减。术后3、6、9、12个月累积生存率和支架通畅率分别为100%、60.0%、46.7%、20.0%和100%、73.3%、40.0%、20.0%。结论采用门静脉支架同步125I粒子条植入联合TACE治疗肝癌合并门静脉癌栓安全、可行。Objective To assess the clinical efficacy of portal vein stenting combined with linear ^125I seed strand implantation and TACE for treatment of hepatocellular carcinoma（HCC）with portal vein tumor thrombus（PVTT）.Methods Fifteen patients with HCC accompanied with PVTT underwent portal vein stenting combined with linear ^125I seed strand implantation and TACE treatment later.The patients were followed-up,and the cumulative survival rate and stent patency rate were calculated.Results Stents and ^125I seed strands were successfully placed in the portal veins in all patients,no severe complications occured,such as puncture bleeding,bile leak and acute liver and kidney failure.Thirty-eight TACE were operated.During follow-up period of 6—12 months,3 patients remained alive,and among 12 dead patients,4 died of gastrointestinal bleeding,2 died of lung metastasis and 6 died of hepatic dysfunction.The survival rates at 3,6,9and 12 month was 100%,60.0%,46.7%,20.0%,and the stent patency rates was 100%,73.3%,40.0%,20.0%,respectively.Conclusion The portal vein stenting combined with linear 125 I seed strand implantation and TACE for treatment of HCC with PVTT is safe and feasible.

关 键 词：癌 肝细胞 门静脉 放射性同位素碘 化学栓塞 治疗性 支架 

分 类 号：R735.7[医药卫生—肿瘤] R816[医药卫生—临床医学]