肝动脉化疗栓塞联合粒子植入治疗肝癌自发性破裂出血的临床研究  

TACE combined with radioactive seed implantation for the treatment of abdominal hemorrhage due to spontaneous rupture of primary hepatocellular carcinoma: a clinical study

作　　者：刘德鑫[1] 王伟[2] 李新丰[2] 叶超平[2] 赖清泉[3] 李伯义[4] 李平[1] 

机构地区：[1]福建医科大学附属第二医院放射科,福建泉州362000 [2]福建医科大学附属第二医院肝胆外科,福建泉州362000 [3]福建医科大学附属第二医院CT-MR室,福建泉州362000 [4]福建医科大学附属第二医院超声科,福建泉州362000

出　　处：《介入放射学杂志》2015年第11期999-1003,共5页Journal of Interventional Radiology

基　　金：福建省卫生厅医学创新课题项目(2012-CXB-23);泉州市科技局课题项目(2012Z46)

摘　　要：目的探讨肝动脉化疗栓塞(TACE)联合粒子植入治疗肝癌自发性破裂出血的临床疗效。方法 50例肝癌自发性破裂出血患者分为单纯组(20例)和联合组(30例),联合组行急症肝动脉栓塞术(TAE)→^(125)I放射性粒子植入→TACE术序贯治疗,单纯组急症TAE术→TACE序贯治疗。治疗1个月后患者均接受彩色多普勒超声、CT检查并比较两组患者AFP水平变化、肿瘤缩小率、1、2年生存率和不良反应。结果联合组AFP正常率、肿瘤缩小率和1、2年生存率分别为85.7%、90%、90%、66.6%,明显高于单纯组的33.3%、65%、55%、30%(均P<0.05);而不良反应方面,两组比较,差异无统计学意义(P>0.05)。结论 TACE联合粒子植入治疗肝癌自发性破裂出血患者,可充分发挥其优势,明显增加治疗效果,并延长患者的生存期。Objective To evaluate the clinical effects of transcatheter arterial chemoembolization （TACE） combined with radioactive seed implantation in treating abdominal bleeding caused by spontaneous rupture of primary hepatocellular carcinoma （HCC）. Methods A total of 50 HCC patients with abdominal bleeding due to spontaneous rupture of hepatic cancer were divided into simple group （n=20） and combination group （n=30）. Emergency transcatheter arterial embolization （TAE） with subsequent CT-guided or ultrasound- guided ^125I seed implantation and TACE were sequentially carried out in the patients of combination group, while TAE with subsequent TACE was performed in the patients of simple group. One month after the treatment, color Doppler ultrasound and CT scan were reexamined in all patients; the serum AFP levels, the reduction rate of tumor size, the one-year and 2-year survival rate, and the adverse reactions were compared between the two groups. Results The negative rate of AFP, the tumor shrinkage rate, the one-year and 2- year survival rates in the combination group were 85.7%, 90%, 90% and 66.6% respectively, which were significantly higher than those in the single group （33.3%, 65%, 55% and 30% respectively）, the differences between the two groups were statistically significant （P〈0.05 for all）. No statistically significant differences in the incidence of adverse reactions existed between the two groups （P〉0.05）. Conclusion In treating abdominal bleeding caused by spontaneous rupture of primary HCC, TACE combined with radioactive ^125I seed implantation can full play their complementary advantages, significantly increase the therapeutic effect, and prolong the patient＇s survival time.

关 键 词：肝细胞癌 破裂 自发性 肝动脉化疗栓塞 ^125I放射性粒子 

分 类 号：R735.7[医药卫生—肿瘤]