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目的：通过对50例中晚期肝癌行介入插管治疗后，总结了作者对不同类型肝癌选择灌注及栓堵治疗的实施体会和疗效分析，意在如何能提高肝癌的介入治疗效果。材料与方法：选择50例原发性或继发性肝癌，采用Seldinger技术，行肝动脉灌注或栓堵，对单纯灌注及灌注加栓堵同时进行的方法作了对比。结果：单纯灌注者32例显效率为40．6％。灌注加栓堵者18例，显效率为88％。并对有门脉癌栓的14例中的6例进行了栓堵，显效者67％。另8例单纯灌注者有效率为37％。结论：灌注加栓堵对结节型肝癌应列为介入治疗的首选方法。对巨块型肝癌的栓堵可采取分次进行。有门脉癌栓形成的患者不应完全视为栓堵禁忌症。有的患者栓堵后同样可出现意外的良好转机。
OBJECTIVE: To summarize the author’s experience in the selection of perfusion and embolization treatment for different types of hepatic cancer after interventional intubation of 50 patients with advanced hepatocellular carcinoma. The purpose of this study is to understand how to improve the interventional effect of liver cancer. Materials and Methods: 50 cases of primary or secondary hepatocellular carcinoma were selected. Hepatic artery perfusion or plug was performed using Seldinger technique. The methods of simple perfusion and perfusion plus embolization were compared at the same time. RESULTS: The effective rate was 32.6% in 32 patients who had simple perfusion. Infusion plus embolism in 18 cases, the effective rate was 88%. Six of the 14 patients with portal vein cancer emboli were treated with embolization, which was 67%. The effective rate of the other 8 cases of simple perfusion was 37%. Conclusion: Perfusion plus embolization should be the first choice for interventional treatment of nodular liver cancer. Thrombosis for massive hepatocellular carcinoma can be performed in divided doses. Patients with portal vein cancer emboli should not be completely considered contraindicated. Some patients may also experience an unexpectedly good turn after plugging.