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本文回顾性分析了19例晚期肝癌伴门脉癌栓病人的介入治疗疗效和肝动脉栓塞的安全性。结果显示19例中有13例肿瘤不同程度的缩小,全部是经加用碘油或明胶海绵栓塞肝动脉的病例。在抗癌药物加碘油、明胶海绵栓塞的肝动脉组中,9例门脉显影者仅1例 ALT 和 AST 升高,而3例门脉未显影者全部升高。因此作者认为:对伴有门脉癌栓的晚期肝癌,只要间接门脉造影显示门静脉,亦应加用碘油和明胶海绵栓塞肝动脉。但对门脉未显影者,用碘油栓塞是安全的,但不宜用明胶海绵栓塞。
This article retrospectively analyzed the efficacy of interventional treatment and the safety of hepatic artery embolization in 19 patients with advanced liver cancer and portal cancer thrombus. The results showed that 13 of the 19 cases had tumors of varying degrees of reduction, all of which were cases of embolization of the hepatic artery with lipiodol or gelatin sponge. In the hepatic artery group with anti-cancer drugs plus lipiodol and gelatin sponge embolization, only one of the 9 portal imagers had elevated ALT and AST, while all three portal arterial images were elevated. Therefore, the author believes that: For advanced liver cancer with portal vein cancer thrombus, as long as the indirect portal vein imaging shows the portal vein, should also be added with lipiodol and gelatin sponge embolization of the hepatic artery. However, for portal vein undeveloped persons, embolization with lipiodol is safe, but gelatin sponge embolization is not recommended.