超声引导经皮肝穿刺放射性^(125)I粒子植入治疗Ⅰ、Ⅱ型门静脉癌栓初步研究  

Preliminary Study on Ultrasound-guided Percutaneous Liver Puncture with Radioactive ^(125)I Seed Implantation in Treatment of Type Ⅰ and Ⅱ Portal Vein Tumor Thrombus

作　　者：亓培君 祖茂衡 鹿皎 许伟 王勇 柳昂 张清飞 QI Pei-jun;ZU Mao-heng;LU Jiao;XU Wei;WANG Yong;LIU Ang;ZHANG Qing-fei(Department of Ultrasound Medicine,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China;Department of Interventional Radiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)

机构地区：[1]徐州医科大学附属医院超声医学科,江苏徐州221006 [2]徐州医科大学附属医院介入放射科,江苏徐州221006

出　　处：《河北北方学院学报（自然科学版）》2022年第10期1-4,9,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的探讨超声引导经皮肝穿刺放射性^(125)I粒子植入治疗Ⅰ、Ⅱ型门静脉癌栓的临床疗效及安全性。方法选取69例原发性肝癌合并Ⅰ、Ⅱ型门静脉癌栓患者,按照引导方式不同分为超声组35例及数字剪影血管造影(digital subtraction angiography,DSA)机组34例,比较2组患者术后缓解率、有效率及局部疼痛、出血等不良反应发生率。结果超声组缓解率(51.4%)高于DSA机组(23.5%)(P<0.05);2组有效率比较差异无统计学意义(P>0.05)。术后3 d患者肝功能及血白细胞计数组间比较差异无统计学意义(P>0.05),各组患者术后3 d与术前比较差异亦无统计学意义(P>0.05)。出血、局部疼痛、恶心呕吐、发热等其他不良反应发生率均较低,组间比较差异无统计学意义(P>0.05)。2组患者术后均未发生腹腔大出血、气胸、胆管损伤、肝脓肿、肝衰竭等严重并发症。结论超声引导经皮肝穿刺放射性^(125)I粒子植入治疗Ⅰ、Ⅱ型门静脉癌栓临床缓解率高于DSA机引导粒子植入治疗,不良反应发生率低,临床应用相对安全。Objective To investigate the clinical efficacy and safety of ultrasound-guided percutaneous liver puncture with radioactive ^(125)I seed implantation in the treatment of type Ⅰ and Ⅱ portal vein tumor thrombus.Methods A total of 69 patients with primary liver cancer complicated with type Ⅰ and Ⅱ portal vein tumor thrombus were divided into an ultrasound group of 35 cases and a digital subtraction angiography(DSA)group of 34 cases according to different guidance methods.Post-remission rate,effective rate and incidence of adverse reactions such as local pain and bleeding were compared between two groups.Results The remission rate in the ultrasound group was 51.4%,which was higher than that in the DSA group(23.5%)(P<0.05).There was no significant difference in the effective rate between the two groups(P>0.05).There was no significant difference in liver function and blood white blood cell count between the two groups 3 days after operation(P>0.05),and there was no significant difference between the two groups 3 days after operation and before operation(P>0.05).The incidences of other adverse reactions such as bleeding,local pain,nausea and vomiting,and fever were lower,and there was no significant difference between the two groups(P>0.05).There were no serious complications such as intra-abdominal hemorrhage,pneumothorax,bile duct injury,liver abscess,and liver failure in the two groups after operation.Conclusion Ultrasound-guided percutaneous liver puncture radioactive ^(125)I seed implantation in the treatment of type Ⅰ and Ⅱ portal vein tumor thrombus has a higher clinical remission rate than DSA machine-guided seed implantation,and the incidence of adverse reactions is lower,and its clinical application is relatively safe.

关 键 词：超声引导 门静脉癌栓 ^(125)I粒子植入 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]