超声引导经皮徒手穿刺^(125)I放射性粒子植入治疗中央型肝癌  

Ultrasound-guided freehand percutaneous ^(125)I seeds implantation for central type carcinoma of liver

作　　者：屈佳[1] 王辉[1] 陈露[1] 杨冬艳[1] Qu Jia;Wang Hui;Chen Lu;Yang Dongyan(Department of Ultrasound,China-Japan Union Hospital of Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院超声科,长春130033

出　　处：《中华医学超声杂志（电子版）》2018年第7期539-542,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声引导经皮徒手穿刺^(125)I放射性粒子植入治疗中央型肝癌的临床价值。方法收集2013年9月至2015年6月吉林大学中日联谊医院15例中央型肝癌患者的临床资料,所有患者均行超声引导经皮徒手穿刺^(125)I放射性粒子植入治疗,评估患者术后肿瘤局部控制率、并发症发生率、术后生存率。结果 15例患者均按照术前治疗计划顺利完成操作,用时0.5~1.5 h,中位时间为0.80 h。对比术前和术后3个月的CT图像,完全缓解(CR)3例,部分缓解(PR)10例,稳定(SD)2例,进展(PD)0例,总有效率为86.7%(13/15)。1例术后即刻出现肝周少量积液,未经治疗好转;1例术后3个月出现腹壁的种植性转移,行腹壁转移灶^(125)I放射性粒子植入治疗,2个月后复查超声显示腹壁转移灶消失,手术并发症发生率为13.4%(2/15)。患者术后3、6、12个月生存率分别为100.0%、100.0%、80.0%。结论超声引导经皮徒手穿刺^(125)I放射性粒子植入治疗中央型肝癌患者创伤小、近期疗效好、并发症少,是一种有效的治疗中央型肝癌的方法。Objective To investigate the clinical value of ultrasound-guided freehand percutaneous 125I seeds implantation for central type carcinoma of liver.Methods The clinical data of 15 patients with central type carcinoma of liver in China-Japan Union Hospital of Jilin University between September 2013 and June 2015 were collected.All patients were performed ultrasound-guided freehand percutaneous 125I seeds implantation.The rates of local control,complication,postoperative survival of all patients were evaluated.Results Fifteen patients were performed successfully according to the preoperative plans.The operation time ranged from 0.5 to 1.5 h with a median time of 0.80 h.By comparison of CT images before and 3 months after operation,there were 3 cases of complete remission(CR),10 of partial remission(PR),2 of stable(SD),and none of progression(PD),with a total effective rate of 86.7%(13/15).A small amount of peri-hepatic effusion appeared immediately after operation in 1 cases,which had a spontaneous improvement without treatment.One case of abdominal wall implant metastasis occurred at 3 months after operation,the incidence of surgical complications was 13.4%(2/15).The survival rates at 3,6 and 12 months after operation were 100.0%,100.0%and 80.0%,respectively.Conclusion Ultrasound-guided freehand percutaneous 125I seeds implantation can be an effective method for patients with central type carcinoma of liver,with less surgical trauma,better short-term efficacy and fewer complications.

关 键 词：肝肿瘤 超声引导 近距离放射疗法 125I放射性粒子 徒手操作 

分 类 号：R735.7[医药卫生—肿瘤]