双导向技术引导下^(125)I粒子植入治疗肝癌合并门静脉癌栓  

^(125)I seeds implantation using dual-guided technique for the treatment of hepatocellular carcinoma associated with portal vein tumor thrombus

作　　者：田玉龙[1] 刘瑞宝[1] 刘岩[1] 李世杰[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院介入科,150040

出　　处：《介入放射学杂志》2015年第9期785-788,共4页Journal of Interventional Radiology

摘　　要：目的探讨超声及DSA联合引导下经导管植入125I粒子治疗肝癌合并门静脉癌栓的可行性、安全性及疗效。方法 30例原发性肝癌合并门静脉癌栓患者行门静脉125I粒子植入术。手术方法采用超声引导经皮经肝穿刺门静脉未受累段,穿刺成功后引入导管,DSA透视下经导管向受累门静脉内植入125I粒子。评价指标包括手术技术成功率、术后并发症、血常规及肝功能改变、癌栓抑制情况、中位生存期。结果所有患者125I粒子均成功植入,未发生手术相关严重并发症。术后随访3~36个月,门静脉癌栓均缩小,中位生存期约7个月。结论超声及DSA联合引导下经导管植入125I粒子治疗肝癌合并门静脉癌栓的方法安全可行,临床操作实用性强,可有效治疗门静脉癌栓。Objective To investigate the feasibility, safety and efficacy of endovascular implantation of ^125I seeds under the dual-guidance of ultrasound and digital subtraction angiography （DSA） for the treatment of hepatocellular carcinoma （HCC） associated with portal vein tumor thrombus. Methods A total of 30 patients with primary HCC complicated by portal vein tumor thrombus underwent implantation of ^125I seeds via portal vein. Guided by ultrasound, percutaneous transhepatic puncturing of portal vein was performed first, then, catheter was inserted, which was followed by transcatheter ^125I seeds implantation into the affected portal vein under DSA guidance. The technical success rate, postoperative complications, routine blood tests, liver function, the suppression of portal vein tumor thrombus and survival time were analyzed. Results Successful implantation of ^125I seeds was achieved in all patients, no serious procedure-related complications occurred. All patients were followed up for 3-36 months, the portal vein tumor thrombus showed a significant shrinkage in all patients. The median survival time was about seven months. Conclusion For the treatment of hepatocellular carcinoma associated with portal vein tumor thrombus, endovascular implantation of ^125I seeds under the dual-guidance of ultrasound and digital subtraction angiography is clinically safe and feasible. This treatment has satisfactory effect on the portal vein tumor thrombus.（J Intervent Radiol, 2015, 24： 785-788）

关 键 词：肝癌 门静脉癌栓 ^125I粒子 超声 DSA 

分 类 号：R735.7[医药卫生—肿瘤]