论文部分内容阅读
目的通过分析经肝动脉不同介入方法对肝癌并门脉主干癌栓患者的治疗作用，评价不同方法的疗效。方法对182例原发性肝癌合并门脉主干癌栓患者行二次以上介入治疗，26例单纯肝动脉内灌注化疗药物（A组），42例化疗加碘油（B组），114例化疗加碘油及明胶海绵颗粒栓塞（C组）。结果①肿瘤缩小率＞50％者，A组0，B组23．8％，C组32．5％，统计学显示相差非常显著（P＜0．001）。②治疗后门脉瘤栓消失率A组为7．7％，不变率为84．6％；B组分别为21．4％、54．8％；C组为37．7％和40．4％。统计显示有显著差异（P＜0．001）。③1、3年生存率分别为A组11．5％，0；B组21．4％，2．4％；C组33．3％，3．6％，C组中有一患者已存活10年。A、B组和B、C组间均差异显著（P＜0．05），A、C组差异非常显著（P＜0．01）。结论对于肝癌并门脉主干癌栓的治疗，TAI疗效不佳，只要选择病人得当，TACE治疗可取得良好的疗效。
Objective To analyze the therapeutic effects of different interventional methods of hepatic artery on patients with hepatocellular carcinoma and portal vein tumor thrombus and evaluate the efficacy of different methods. Methods Two hundred and eighty-two patients with primary hepatocellular carcinoma combined with portal vein tumor thrombus were treated with two or more interventions. Twenty-six patients received intrahepatic intra-arterial chemotherapy alone (group A), 42 patients received chemotherapy plus lipiodol (group B), and 114 patients received chemotherapy. Lipiodol and gelatin sponge particles were embolized (group C). Results 1 The tumor shrinkage rate was more than 50%, group A 0, group B 23.8%, group C 32.5%, statistically significant difference (P <0.001). After treatment, the disappearance rate of portal vein tumor emboli in group A was 7.7%, and the invariable rate was 84.6%; in group B, it was 21.4% and 54.8%; in group C, 37.7% and 40. 4%. Statistics show a significant difference (P<0.001). The 31-year and 3-year survival rates were 11.5% in group A, 0, 21.4% in group B, and 2.4% in group B, and 33.3% in group C and 3.6% in group C. One patient in group C had survived for 10 years. . There was a significant difference between group A and group B and group B and group C (P<0.05). The difference between group A and group C was significant (P<0.01). Conclusions For the treatment of hepatocellular carcinoma and portal vein tumor thrombus, TAI is not effective. As long as the patient is properly selected, TACE can achieve good results.