门静脉植入放射性支架联合肝动脉化疗栓塞治疗肝癌伴门静脉癌栓的疗效评估  

Efficacy of percutaneous transhepatic portal vein stent implantation combined with transcatheter arterial chemoembolization treatment in hepatocellular carcinoma patients with portal venous tumor emboli

作　　者：雷振武[1] 

机构地区：[1]青海大学附属医院介入科,青海西宁810001

出　　处：《中国现代医学杂志》2016年第23期111-114,共4页China Journal of Modern Medicine

摘　　要：目的分析门静脉植入放射性支架联合肝动脉化疗栓塞(TACE)治疗肝癌伴门静脉癌栓(PVTT)的疗效。方法 86例肝癌伴PVTT患者随机分为观察组及对照组,各43例。对照组患者接受TACE治疗,观察组患者接受门静脉植入放射性支架联合TACE治疗,对比两组患者治疗后的肝功能水平、肝癌活性相关指标及术后生存时间差异。结果观察组患者治疗后的血清谷丙转氨酶、谷草转氨酶、总胆红素水平低于对照组,差异有统计学意义(P<0.05);观察组血管内皮生长因子、甲胎蛋白异质体、细胞间黏附分子、E钙黏连蛋白、基质金属蛋白酶水平均低于对照组,差异有统计学意义(P<0.05);随访后无症状生存时间、平均生存时间观察组长于对照组,1年生存率观察组高于对照组,差异有统计学意义(P<0.05)。结论肝癌伴PVTT患者接受门静脉植入放射性支架联合TACE治疗,有助于肝功能提高及肝癌活性降低,对延长患者生存时间有积极作用。Objective To analyze the efficacy of percutaneous transhepatic portal vein stenting（PTPVS）combined with transcatheter arterial chemoembolization（TACE） treatment on hepatocellular carcinoma（HCC）patients with portal venous tumor emboli. Methods Totally 86 cases of hepatocellular carcinoma patients with portal vein tumor emboli were randomly divided into observation group and control group, each with 43 cases.The control group received TACE therapy, while the observation group received PTPVS combined with TACE treatment. Liver function level, liver cancer activity related indicators and survival time after treatment were compared between the two groups. Results After treatment, serum ALT, AST, TBIL, VEGF, AFP-L3, ICAM-1,EC and MMP levels in the observation group were significantly lower than those in the control group（P〈0.05）. After follow-up, asymptomatic survival time and average survival time in the observation group were longer than those in the control group patients, 1-year survival rate in the observation group was higher than that in the control group, the differences were statistically significant（P〈0.05）. Conclusions PTPVS combined with TACE treatment can enhance liver function and decrease liver cancer activity in HCC patients with portal venous tumor emboli, and has a positive effect on prolonging survival time of the patients.

关 键 词：肝癌 门静脉癌栓 肝动脉化疗栓塞 行经皮穿刺门静脉支架植入术 

分 类 号：R735.7[医药卫生—肿瘤]