摘要
目的探讨巨大肝癌行肝动脉、门静脉双栓塞的方法及疗效。方法47例无法行一期手术切除的巨大肝癌并乙肝肝硬化患者,经选择性肝动脉栓塞(TACE)和门静脉栓塞(SPVE),观察其治疗后疗效、并发症及生存时间。结果12例患者于SPVE后1～3个月行肝癌切除术(切除组),切除组中无围手术期死亡病例,另35例未行手术治疗(非切除组)。非切除组35例生存时间为5～17(7.3±3.7)个月,1年生存率为14.3%,无存活达2年病例。切除组生存时间5～49(15.6±11.7)个月,1和2年生存率分别为75.0%和16.7%。切除组的生存时间及1年生存率均显著高于非切除组(P<0.05,P<0.01)。结论肝动脉并门静脉双栓塞对治疗无一期手术切除的巨大肝癌是可行的,在适当的病例可争取二期手术切除机会,以期更好的治疗效果。
[ Objective ] To explore the methods and effects of transcatheter arterial and portal vein embolization of large hepatocellular carcinoma （HCC）. [Methods] Totally 47 cases of large HCC, which were complicated with liver cirrhosis and had no indication of surgical resection for poor liver compensation, accepted transcatheter arterial chemoembolization （＇FACE） and selective portal vein embolization （SPVE）. And their clinical data were collected and analyzed. [Results] Liver resection proceeded in 12 patients 1-3 months after SPVE, with no patient died in the peri-operative duration, while the remaining 35 patients accepted conservational treatment. The patients that accepted liver resection achieved a survival of 5 to 49 [averaged （15.6±11.7）] months, with 1-year and 2-year survival rates of 75.0% and 16.7%, which were significantly longer or higher than those of patients accepting conservational treatment who survived for 5 to 17 [averaged （7.3±3.7）] months with 1-year and 2-year survival rates of 14.3% and 0% （P 〈0.05, P 〈0.01）. [ Conclusions ] Transcatheter arterial and portal vein embolization might be benefit to patients of unrescetable large HCC. It could strive for a chance of cancer resection in some cases latterly, which might achieve a better clinical effect.
出处
《中国内镜杂志》
CSCD
北大核心
2009年第8期889-891,共3页
China Journal of Endoscopy
关键词
肝细胞癌
门静脉栓塞
肝动脉栓塞
巨大肝癌
手术切除
hepatocellular carcinoma
portal vein embolization
hepatic artery embolization
large liver cancer
liver resection
