门脉内支架同步^(125)I粒子条植入序贯经肝动脉化疗栓塞治疗原发性肝癌合并门脉癌栓的效果  

Effect of synchronous iodine-125 seed strand implantation and transcatheter arterial chemoembolization in the treatment of primary hepatocellular carcinoma combined with portal vein main tumor thrombus

作　　者：林介军 卢立杰 金小军 鲍洛文 LIN Jiejun;LU Lijie;JIN Xiaojun;BAO Luowen(Department of Gastroenterology,Wenzhou Central Hospital,Zhejiang Province,Wenzhou 325000,China)

机构地区：[1]浙江省温州市中心医院消化内科,浙江温州325000

出　　处：《中国医药导报》2018年第17期85-88,共4页China Medical Herald

基　　金：浙江省温州市科技局基金项目(Y20130280)

摘　　要：目的探讨门静脉金属支架同步^(125)I粒子条植入序贯经肝动脉化疗栓塞(TACE)治疗原发性肝癌合并门脉癌栓(PVTT)患者的临床效果。方法选择2013年7月~2016年12月温州市中心医院符合纳入标准的原发性肝癌伴门静脉主干癌栓患者21例作为研究对象,行门静脉内金属支架及^(125)I粒子条植入序贯TACE治疗并进行随访。结果共植入21枚门静脉支架,植入粒子10~18枚/例。所有患者门静脉支架和^(125)I粒子条均成功植入,手术成功率为100%,未发生手术相关严重并发症。21例患者共接受38次TACE治疗,平均(1.8±0.9)次。术前及术后30 d总胆红素、凝血酶原时间、白蛋白和白细胞计数比较,差异均无统计学意义(P>0.05)。患者平均生存期为(389.1±79.9)d,中位生存期为358.0 d。术后90、180 d和360 d的累积生存率分别为95.2%、66.7%和47.6%,支架通畅率分别为100.0%、76.2%和57.0%。结论 门脉内金属支架同步^(125)I粒子条植入联合TACE治疗原发性肝癌合并门静脉主干癌栓的临床效果较好,值得临床进一步推广应用。Objective To evaluate the clinical effect of synchronous iodine-125（^（125）I） seed strand implantation and transcatheter arterial chemoembolization（TACE） in the treatment of primary hepatocellular carcinoma combined with portal vein main tumor thrombus（PVTT）. Methods From July 2013 to December 2016, 21 patients with hepatocellular carcinoma complicated by PVTT in Wenzhou Central Hospital were selected as the research subjects. Intravenous metal stents and^（125）I seed strips were implanted in sequential TACE therapy and all patients were followed up. Results A total of 21 portal vein stents were implanted and 10-18 particles per person. All patients were successfully implanted portal vein stents and^（125）I particle strips, with 100% success rate. No serious complications related to surgery occurred. A total of 38 times in 21 patients received TACE treatment, with an average of（1.8 ±0.9） times. There were no statistically significant differences in total bilirubin, prothrombin time, albumin and leukocyte counts between preoperative and postoperative of 30 d（P〉0.05）. The mean survival time of patients was（389.1±79.9）d and the median survival time was 358.0 d. The cumulative survival rates of 90, 180 d and 360 d were 95.2%, 66.7% and 47.6%, respectively. The stent patency rates were 100.0%, 76.2% and 57.0%, respectively. Conclusion The clinical effect of synchronous^（125）I seed strand implantation and transcatheter arterial chemoembolization in the treatment of primary hepatocellular carcinoma combined with portal vein main tumor thrombus is better. It is worthy of clinical promotion and application.

关 键 词：癌 肝细胞 (125)I粒子 支架 经动脉化疗栓塞术 门脉 癌栓 

分 类 号：R735.7[医药卫生—肿瘤]