经肝动脉同时直接经门静脉联合介入治疗原发性肝癌  

Treatment of primary hepatic carcinoma by transcatheter artery combined with portal vein chemoembolization

作　　者：贾科峰[1] 于长路[1] 孙诚[1] 韩玉娟[1] 王凤梅[2] 经翔[3] 张传山[4] 

机构地区：[1]天津市第三中心医院放射科,天津300170 [2]天津市第三中心医院消化科,天津300170 [3]天津市第三中心医院超声科,天津300170 [4]天津市第三中心医院病理科,天津300170

出　　处：《实用放射学杂志》2017年第8期1269-1272,共4页Journal of Practical Radiology

基　　金：天津市卫生局科技基金项目（2014KZ013）.

摘　　要：目的 比较同时经肝动脉、门静脉介入与肝动脉介入治疗原发性肝癌的临床疗效.方法 收集本院拟行原发性肝癌介入的患者48例,随机分为肝动脉组和双介入组,肝动脉组行常规肝动脉介入,双介入组行肝动脉、门静脉介入.比较2组术后临床有效率、肝脏体积、肝功能等情况.结果 至观察终点,双介入组有效率、肿瘤直径下降程度都优于肝动脉组;双介入组术后第1天、第3天转氨酶及胆红素等指标较肝动脉组高,术后第7天、第14天,2组无显著性差异;双介入组非栓塞侧体积与术前相比有不同程度增大,其中术后第4周最为明显.2组均未出现治疗相关死亡及严重不良反应.结论 肝动脉同时门静脉介入治疗能有效控制和缩小原发性肝癌,并能有效地诱导肝非栓塞叶代偿性增生,是安全有效的治疗方法.Objective To compare the clinical efficacy and postoperative liver function in patients with primary hepatic carcinoma treated by transcatheter arterial chemoembolization（TACE） or TACE combined with portal vein chemoembolization.Methods 48 patients with primary hepatic carcinoma, randomly divided into 2 groups （hepatic artery group in 25 cases and dual interventional group in 23 cases）,underwent interventional treatment.The hepatic artery group underwent conventional hepatic artery interventional therapy, while the dual interventional group underwent hepatic artery and portal vein interventional treatment.The postoperative clinical efficiency, liver volume and liver function between the two groups＇＇ patients were compared.Results To the endpoint of observation,the clinical efficacy and tumor reduction degree of dual interventional group were better than that of hepatic artery group.Compared with hepatic artery group, the postoperative ALT, AST and TBIL of dual interventional group were higher on the first and third days.On the seventh and fourteenth days, the statistical difference was not significant.The volume of non-embolization part in dual interventional group was larger than that in preoperative volume to different degrees.The most obvious change of liver volume happened in the 4th weeks after treatment.There was no treatment-related death or severe adverse reaction in two groups.Conclusion The treatment of TACE combined with portal vein chemoembolization is a safe and effective method, which may effectively inhibit the growth and reduce the volume of tumor, and result in compensatory hypertrophy of non-embolization part.

关 键 词：原发性肝癌 肝动脉化疗栓塞术 门静脉栓塞 肝体积 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]