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目的:评价肝动脉栓塞化疗(TACE)联合经皮肝沸生理盐水注入法治疗肝细胞癌的疗效及应用价值。方法:选取单个病灶直径<5.0cm,或病灶数≤3个且直径≤3.0cm的临床和影像学确诊的肝细胞癌患者18例,共23个结节,先行TACE1～2次,间隔1～2个月后在CT导引下行经皮肝沸生理盐水注射1～3次,每次注射15～50mL。并监测肝功能、甲胎蛋白(AFP),影像学复查和临床随访18个月。结果:所有病例的肝功能明显改善,AFP明显下降,11例AFP正常。CT复查示23个病灶碘油沉积良好15个,较好5个,差3个。所有病灶均有缩小,缩小20%者7个,缩小50%者12个,缩小80%者4个。随访6个月生存率100%(18/18),12个月生存率94%(17/18),18个月生存率83%(15/18)。结论:TACE联合经皮肝沸生理盐水注入治疗肝癌的疗效肯定,尤其适用于不愿手术的患者。
Objective: To evaluate the efficacy and clinical value of transcatheter hepatic arterial chemoembolization (TACE) combined with percutaneous transhepatic injection of normal saline into hepatocellular carcinoma. Methods: Totally 23 nodules were enrolled in this study. Eighteen patients with clinically and radiologically diagnosed hepatocellular carcinoma with a single lesion diameter <5.0cm or ≤3 lesions and ≤3.0cm in diameter were enrolled in this study. 2 months after the CT guided percutaneous transcutaneous hepatic saline injection 1 to 3 times, each injection of 15 ~ 50mL. Liver function, AFP, imaging review, and clinical follow-up of 18 months were monitored. Results: The liver function was significantly improved in all cases, AFP was significantly decreased, 11 cases of AFP normal. Computed tomography showed that in the 23 lesions, lipiodol deposition was good 15, better 5 and worse 3. All lesions were reduced, reduced 20% 7, 50% reduced 12, reduced 80% 4. The follow-up 6 months survival rate was 100% (18/18), 12 months survival rate was 94% (17/18), 18 months survival rate was 83% (15/18). Conclusion: TACE combined with percutaneous transhepatic injection of normal saline for the treatment of liver cancer has a definite effect, especially for patients who do not want surgery.