论文部分内容阅读
目的 探讨不同方法治疗原发性肝癌合并门静脉癌栓的疗效。 方法 回顾性分析我院 1995年 1月~2003年 12月收治的 132例肝癌合并门静脉癌栓的临床资料。根据不同方法分成 4组:保守治疗组 19例,化疗组 38例,手术切除组 20例,综合治疗组 55例。 结果 保守治疗组、化疗组、手术切除组与综合治疗组中位生存时间分别为 3. 3、6. 8、10. 0、13. 8个月。综合治疗组术后 0. 5、1、2和 3年生存率分别为 52. 7%、36. 4%、30. 9%和 12. 7%,明显高于其他三组(P<0. 01)。肿瘤大小、肝切缘有无癌残留及术后化疗次数是影响手术切除后疗效的重要因素。 结论 门静脉癌栓患者能耐受手术者应积极行肝癌切除并术中取栓治疗,而手术切除加术后化疗的疗效最佳。
Objective To investigate the curative effect of different methods in treating primary hepatic carcinoma with portal vein tumor thrombus. Methods The clinical data of 132 patients with hepatocellular carcinoma complicated with portal vein tumor thrombus admitted in our hospital from January 1995 to December 2003 were retrospectively analyzed. According to different methods, the patients were divided into 4 groups: conservative treatment group (19 cases), chemotherapy group (38 cases), surgical resection group (20 cases) and comprehensive treatment group (55 cases). Results The median survival time of conservative treatment group, chemotherapy group, surgical resection group and comprehensive treatment group were 3. 3,6. 8,10. 0,13. 8 months respectively. The 0.5, 1, 2 and 3-year survival rates of the combined treatment group were 52.7%, 36.4%, 30.9% and 12.7%, respectively, which were significantly higher than those of the other three groups (P <0.05). 01). The size of the tumor, the presence or absence of cancer at the hepatic margin and the number of postoperative chemotherapy are important factors influencing the curative effect after resection. Conclusion Patients with portal vein thrombosis who can tolerate surgery should be actively performed resection of liver cancer and intraoperative thrombectomy, and surgical resection plus the best effect of postoperative chemotherapy.