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目的:探讨大剂量碘油栓塞治疗巨块型富血管肝癌的疗效。方法:使用Seldinger穿刺方法,经股动脉置管行肝动脉栓塞化疗治疗巨块型富血管肝癌,一次超液态碘油剂量20～60mL。结果:98例患者接受大剂量超液态碘油栓塞化疗治疗,肝功能Child-Pugh A级者,肝功能损害不大,患者能耐受,与常规剂量栓塞组相比,无显著差别(P>0.05),其1～2、2～3、>3年生存率为77%、52.6％和18％,常规剂量栓塞治疗组为58.1％,32.5％和9％。大剂量超液态碘油栓塞较常规剂量栓塞治疗生存率高(P<0.05)。结论:大剂量碘油栓塞治疗巨块型富血管肝癌疗效较常规剂量栓塞治疗组好,其副作用无明显增加,该治疗方法可行。建议对肝功能 Child-Pugh A级者行大剂量超液态碘油栓塞治疗。
Objective: To investigate the efficacy of high-dose lipiodol embolization in the treatment of massive hepatocellular carcinoma. Methods: Seldinger puncture method was used to treat massive bulky hepatocellular carcinoma via transcatheter hepatic arterial chemoembolization. The dosage of ultra-liquid iodized oil was 20-60 mL. Results: Ninety-eight patients were treated with high-dose lipiodol embolization and chemotherapy. The Child-Pugh A grade of liver function was not impaired in liver function, and the patients were tolerant. Compared with the conventional dose embolization group, there was no significant difference (P> 0.05). The 1-, 2-, 3-, 3-year survival rates were 77%, 52.6% and 18%, respectively, and were 58.1%, 32.5% and 9% respectively in the conventional dose embolization group. High-dose ultra-liquid iodized oil embolization than conventional dose embolization survival rate (P lt; 0.05). Conclusion: The effect of high-dose lipiodol embolization in the treatment of massive hepatocellular carcinoma is better than that of the conventional dose embolization group, with no significant increase in side effects. This treatment is feasible. It is recommended for the liver function Child-Pugh A-class high-dose ultra-liquid lipiodol embolization.