摘要
目的观察经导管动脉灌注栓塞化疗联合射频消融和无水乙醇化学消融术治疗原发性肝癌的近期疗效。方法60例病例，其中男性47例，女性13例，平均年龄为49岁。均采用经肝动脉灌注化疗栓塞（transcatheter arterial chemoembolization，TACE），治疗次数2～5次；19例（31．67％，19／60）病灶碘油沉积良好，经CT或MRI证实无肿瘤存活，进行追踪观察；41例（68．33％，41／60）影像学检查示病灶碘油沉积不良，联合射频消融术（radiofrequency ablation，RFA）治疗1—3次，部分病例在RFA治疗同时瘤内注射无水酒精。术后增强CT或MRI随访，检测血AFP值。同时观察1，3，6个月生存率。结果本组60例病人随访6个月影像检查59例显示肿瘤均有不同程度的缩小；联合RFA和PEI治疗的癌灶坏死更为彻底。49例（81．67％，49／60）A清AFP值下降率〉50％，11例〈50％（18．33％，11／60），其中3例（5．0％，3／60）〈20％，1例Child C级晚期肝癌病人因多器官功能衰竭3个月后死亡。1，3，6个月生存率分别为100％，100％，98．33％。结论肝动脉灌注栓塞化疗结合射频消融和无水乙醇化学消融术是治疗肝癌的有效方法。
Objective To evaluate the therapeutic effect and the indication of the combination of transcatheter arterial chemoembolization and radiofrequency ablation in the primary hepatic carcinoma. Methods We retrospectively analyzed the data of 60 patients （M ： F = 47 ： 13, mean age 49 years） with primary hepatic carcinoma,who received treatment of the transcatheter arterial chemoembolization procedure. The complete necrosis rate of TACE was 19 （31.67%, 19/60）, 49 patients（81.67%, 49/60）,whose lesion without complete necrosis were treated with RFA and PEI after transcatheter arterial chemoembolization. Contrast-enhanced CT/MRI was performed for the patients before and after RFA. Liver function and serum alpha-fetoprotein （AFP） were measured for all patients. Changes of the lesions on contrast-enhanced CT/MRI were evaluated for assessing the therapeutic responses. The 1-, 3-, 6-month survival rates were recorded after treatment.Results Of the 60 patients, 59 （98.33%） showed the volume of the lesions were deceased in different level. There are more complete necrosis rate of lesions in the combination treatment group. 49 （81.67%） patients＇serum AFP level declined more than 50%, and less than 50%in 11 cases（18.33%, 11/60）; The 1-, 3-, 6- month survival rate after treatment was 100% （60/60）, 100% （60/60）, 98.33% （59/60）, respectively. Conclusion For HCC （diameter〉3cm）, the combined treatment of transcatheter arterial chemoembolization and radiofrequency ablation should be used.
出处
《中华临床医学杂志》
2007年第5期18-21,共4页
Chinese Journal of Clinical Practical Medicine
关键词
原发性肝癌
经导管动脉灌注化疗栓塞射
频消融
无水乙醇化学消融
联合治疗
疗效
Primary hepatic carcinoma
Transcatheter arterial chemoembolization
Radiofrequency ablation
Percutaneous ethanol injection
Therapeutic alliance
Curative effect
