经皮注射无水乙醇经注射无水乙醇.doc

经皮注射无水乙醇-碘油乳剂配合TACE治疗肝癌 字号:? 小? 中? 大? | 打印 发布: 2007-10-04 17:13 ?? 作者: 王炳良 黄克勇 黄晓明 ?? 来源: 本站原创 ?? 查看: 341次 【摘要】 目的? 观察CT引导下经皮穿刺癌灶内注射无水乙醇碘油乳剂（Percutaneous Ethanol-Lipiodol Injection，PELI）配合肝动脉化疗栓塞（transcatherter arterial chemoembolization，TACE）治疗肝癌的疗效。 方法? 64例原发性肝癌患者被随机分为两组。其中32例作为研究组接受TACE+经皮瘤内注射无水乙醇-碘油乳剂治疗；另外32例作为对照组，接受单纯TACE治疗。两组患者的Child分级无显著差异（P＞0.05）。结果? 治疗结束3个月后比较患者治疗前后AFP降低程度和肿块缩小情况，差异有显著性（P＜0.05），研究组和对照组1、2年生存率分别为96%/78%和81%/48%。? 结论? PELI配合TACE治疗原发性肝癌较单纯TACE治疗具有更好的临床疗效。【关键词】原发性肝癌 ； 肝动脉化疗栓塞 ；乙醇 ； 碘化油 ；介入治疗[Abstract]? Objective? To observe the clinical curative effect of percutaneous ethanol-Lipiodol injection（PELI） under CT guidance combined with transcatheter arterial chemoembolization（TACE）for primary hepatocellular carcinoma. Methods? 64 cases were divided into two groups at random, study group and control group. 32 cases with primary hepatocellular carcinoma as study group were treated with TACE plus PELI; the other 32 cases as control group were treated with TACE alone . There was no significant difference between the Child-Pugh stage of both groups（P＞0.05）.?? Results? After 3 months of treatment, a significant diffference（P＜0.05）was revealed by comparing AFP decrease and tumor mass reduction. The survival rate for 1-2 years of the study group and control group were 96%/78% and 81%/48% respectively.? Conclusion??? The results showed that the clinical curative effect of PELI combined with TACE is superior to TACE alone for patients with primary hepatocellular carcinoma.[Key words] Primary hepatocellular carcinoma ; Transcatheter arterial chemoembolization;? Ethanol;? Lipiodol;? Interventional treatment 肝癌是国内常见的恶性肿瘤之一，一般认为外科切除是肝癌的根治方法，但手术切除率一直很低，许多病人发现时因合并肝硬化、肝功能不良或肿块过大、多发病灶等因素而不能行外科治疗。对不能手术治疗的肝癌，经导管肝动脉化疗栓塞术（Transcatheter arterial chemoembolization, TACE）是常用的治疗方法，但是单纯行TACE治疗，效果常不尽如人意，其原因在于许多病灶有肝外动脉供血、门静脉末梢分支供血以及TACE后肝动脉闭塞致多侧枝供血等。另外，多次的TACE治疗也会导致肝功能损害加重。近年来，作者采用经皮穿刺注射无水乙醇-碘油乳剂配合TACE治疗不能手术切除的肝癌，取得了较好的治疗效果。自2004年1月开始，作者选择肝功能分级较好的64例原发性肝癌患者进行了经皮瘤内注射无水乙醇