超声引导下经皮穿刺治疗门静脉癌栓的疗效探讨  

Therapeutic effect of ultrasound-guided percutaneous portal vein puncture on treatment of portal vein tumor thrombus

作　　者：朱东升[1] 吴志华[1] 彭国林[1] 王小娟[1] 彭亮[1] 刘英棣[2] 

机构地区：[1]解放军第一八四医院超声科,江西省鹰潭市335000 [2]上海长征医院超声科

出　　处：《临床超声医学杂志》2015年第7期488-490,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声引导下经皮穿刺治疗原发性肝癌合并门静脉癌栓的疗效。方法 31例肝门静脉癌栓患者经超声引导注射无水乙醇和羟喜树碱,每2～3周注射1次,连续治疗3～5次为一个疗程,每个疗程结束后随访1～2个月。结果根据癌栓对门静脉阻塞程度的不同,31例患者分为3级：1级11例,2级15例,3级5例。治疗后22例患者癌栓缩小,总有效率为70.9%。31例患者中25例死亡,平均生存期（6.9±3.3）个月,所有患者均未发现新的肿瘤病灶;无一例发生门静脉周围药物渗出、出血、感染等严重并发症,患者腹胀减轻,腹水减少。结论超声引导下经皮穿刺门静脉癌栓注射无水乙醇和羟喜树碱是治疗门静脉癌栓的一种有效方法。Objective To evaluate the therapeutic effect of ultrasound-guided intervention on treatment of primary hepatic carcinoma with portal vein tumor thrombus.Methods Absolute ethyl alcohol and camptothecin were injected into the tumor thrombus of portal vein guided by ultrasound in thirty-one patients.The operation was carried out one time every two or three weeks and the course of the treatment involved three to five times injections continuously.Results A total of 31 cases were divided into three grades according to the blockage level of portal vein tumor thrombus（11 cases in grade 1,15 cases in grade2,5 cases in grade 3）.The tumor thrombus became smaller in 22 patients,the total effective rate was 70.9%.25 cases died and the mean survival time was（6.9±3.3）months.New lesion was not found in all the patients.There were no serious complications,such as drug leakage,hemorrhage and infection.Abdominal distension and ascites were alleviated.Conclusion Percutaneous portal vein injection with absolute ethyl alcohol and camptothecin is an effective method to treat the portal vein tumor thrombus.

关 键 词：超声引导 门静脉癌栓 无水乙醇 羟喜树碱 原发性肝癌 

分 类 号：R445.1[医药卫生—影像医学与核医学]