论文部分内容阅读
化疗结合肝动脉栓塞可明显提高不能切除的肝细胞癌患者的生存率.本文作者对一欧州医疗中心采用肝动脉化疗药栓密(HCE)治疗肝癌的效果进行了评价。1984年5月至1989年12月共施行 HCE 328例,其中291例为肝癌,年龄平均为56岁(15～77岁),多数为男性,80%原有肝硬变。按 Okuda 法分类,计Ⅰ期150例、Ⅱ期121例、Ⅲ期20例。先做腹腔动脉造影,排除迷走肝右动脉。如肿瘤栓塞已扩展至门静脉分叉或主干,则列为 HCE 的禁忌证。动脉导管插入肝左(或右)动脉,栓塞剂由10～15ml乙碘油和50 mg 阿霉素组成的乳剂。1989年4月以前采用明胶海绵作栓塞,此后改用明胶海绵微粒.在荧光屏下监视药物灌注情况及栓塞部位。结果:(一)60天内死亡率:正常肝脏者为7%,肝硬变 A、B 和 C 级分别为2.8%、8%和37%。(二)并发症:共发生胆囊炎10%、血管炎14%,十二指肠溃疡6例、肝脓肿4例、脾梗塞3例、胰腺炎
Chemotherapy combined with hepatic artery embolization can significantly increase the survival rate of patients with unresectable hepatocellular carcinoma. The authors evaluated the efficacy of hepatic arterial chemoembolization (HCE) in the treatment of liver cancer at an European medical center. From May 1984 to December 1989, a total of 328 HCEs were performed, of which 291 were liver cancers, and the average age was 56 years (15-77 years). Most of them were male and 80% had cirrhosis. According to the Okuda method, there were 150 patients in phase I, 121 in phase II, and 20 in phase III. Celiac arterial angiography was first performed to exclude the right vagal artery. If the tumor embolism has spread to the portal vein bifurcation or trunk, it is classified as a HCE contraindication. The arterial catheter was inserted into the left (or right) artery of the liver, and the embolization agent consisted of an emulsion consisting of 10-15 ml of ethyl iodine oil and 50 mg of doxorubicin. Prior to April of 1989, gelatin sponges were used as embolizations. Afterwards, gelatin sponge particles were used. The perfusion and embolization sites were monitored under the fluorescent screen. Results: (i) Mortality within 60 days: 7% for normal livers, 2.8%, 8%, and 37% for cirrhosis A, B, and C grades, respectively. (B) complications: a total of 10% cholecystitis, vasculitis 14%, 6 cases of duodenal ulcer, 4 cases of liver abscess, 3 cases of splenic infarction, pancreatitis