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目的 分析B超引导下经皮肝穿刺门静脉及瘤体内药物联合治疗 (CPTIII)肝癌及控制其肝内播散的疗效。方法 12例肝癌伴门静脉癌栓已失去手术机会的中晚期肝癌患者行 3次CPTIII,每次间隔 7天。结果 B超复查 :首次CPTIII后 7天所有患者门静脉癌栓均有缩小 ,完成 3次CPTIII后 7天 7例完全消失 ,5例明显缩小 ,缩小率和消失率分别为 10 0 %及 5 8.3% ,所有肝内 <2 .6cm的癌灶均消失 ,10cm以上主癌灶显著缩小 ,未见新灶 ;B超引导下穿刺主癌灶行针吸细胞学检查仅见坏死组织。患者一般情况好转 ,食欲增加 ,腹胀减轻 ,腹水不同程度消退 ,近期临床效果显著。结论 CPTIII操作简单、安全、适应证广 ,在快速消除门静脉癌栓以控制肝癌肝内播散及使癌灶缩小或消失和临床方面疗效确实
Objective To analyze the curative effect of B-guided percutaneous hepatic pricking portal vein and intratumor drug combination therapy (CPTIII) on hepatocellular carcinoma and control its intrahepatic metastasis. Methods Twelve CPTIII patients with advanced hepatocellular carcinoma who had lost their chances of surgery in 12 patients with hepatocellular carcinoma and portal vein tumor thrombus were treated for 7 days at a time. Results B-scan: all the patients with portal vein tumor thrombus were reduced 7 days after the first CPTIII, 7 cases disappeared completely 7 days after the completion of 3 CPTIII, 5 cases were significantly reduced, the rate of shrinkage and disappearance were 10% and 5 8.3% , All intrahepatic <2. 6cm foci disappeared, 10cm above the main lesion was significantly reduced, no new foci; B-guided primary foramen puncturing needle aspiration cytology only necrotic tissue. Patients generally improved, increased appetite, reduced abdominal distension, ascites subsided in varying degrees, the recent clinical significant. Conclusions CPTIII is simple, safe and widely used in indications. It is effective in rapidly eliminating portal vein tumor thrombus to control hepatic metastasis and shrinking or disappearance of foci