CT在肝癌综合介入治疗决策中的应用价值  

The value of CT in the decision of comprehensive interventional treatment for liver cancer

作　　者：吕江[1] 陈石山 全超明 谭海葵[1] 庞亮明[1] Lyu Jiang;Chen Shishan;Quan Chaoming;Tan Haikui;Pang Liangming(Zhanjiang Central Hospital,Zhanjiang 524000,China)

机构地区：[1]湛江中心人民医院,524000

出　　处：《国际医药卫生导报》2020年第3期367-370,共4页International Medicine and Health Guidance News

摘　　要：目的分析CT在肝癌综合介入治疗决策中的应用价值。方法根据收集本院2012年1月至2015年1月272例次接受肝癌综合介入治疗患者的CT表现,分析治疗策略,统计生存时间。结果新发癌灶、富或中等供血、肝硬化I或II级、存在肝外供血患者多数采取经皮肝动脉造影+化疗栓塞术(TACE)治疗。无复发、乏供血、存在门脉癌栓、动静脉瘘患者多采用经皮肝动脉造影+灌注化疗术(TAI)治疗。肝癌TACE治疗后,多采用经皮肝穿瘤灶无水酒精消融术(PEI)或辅助治疗,以巩固疗效。本组患者Child-Pugh A级患者1年、3年、5年生存率分别为71.13%、46.15%、16.46%,中位生存期39.6个月;Child-Pugh B级患者1年、3年、5年生存率分别为43.10%、24.19%、13.32%,中位生存期23.1个月。结论CT在肝癌综合介入治疗决策中有着重要的临床意义,实现了能够对于不同阶段类型肝癌患者制定个体化的介入治疗方案,为延长肝癌患者生存期做出了重要贡献。Objective To analyze the value of CT in the decision of comprehensive interventional treatment for liver cancer.Methods According to the CT findings of 272 patients with liver cancer undergoing comprehensive interventional treatment in our hospital from January 2012 to January 2015,the treatment strategies were analyzed,the survival time was recorded.Results Most patients with neocancerous lesion,rich or moderate blood supply,grade I or II liver cirrhosis,extrahepatic blood supply were treated with TACE.Most patients with no recurrence,lack of blood supply,portal vein embolus,arteriovenous fistula were treated with TAI surgery.After TACE treatment for liver cancer,PEI surgery or adjuvant therapy was used to consolidate the effect.The 1-year,3-year,and 5-year survival rates of Child-Pugh A patients in this group were 71.13%,46.15%,and 16.46%,and the median survival period was 39.6 months.The 1-year,3-year,and 5-year survival rates of Child-Pugh B patients were 43.10%,24.19%,12.32%,and the median survival period was 23.1 months.Conclusions CT has important clinical significance in the decision of comprehensive interventional treatment for liver cancer.It has realized the individualized interventional treatment scheme for different stages of liver cancer,and has made important contribution to extending the survival period of liver cancer patients.

关 键 词：断层摄影术 X射线计算机 肝癌 肝动脉化疗栓塞 酒精消融 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]