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目的 观察超声引导下肝癌直接介入化疗的疗效。方法 超声引导下肝穿直接介入化疗治疗 2 0例肝癌。原发性肝癌 14例 ,转移性肝癌 6例。Ⅰ期 4例 ,Ⅱ期 12例 ,Ⅲ期 4例。药物为吡柔比星 (THP) 40～ 6 0mg/m2 、MMC4～10mg和卡铂 40 0mg/m2 ,稀释至 10～ 30ml,每 3周一次 ,三次为 1疗程 ,共计 12 8例次。结果 部分缓解 (PR) 15例 ,稳定(NC) 2例 ,恶化 (PD) 3例。 4例二期手术切除。 14例肝区胀痛治疗后 ,12例完全消失 ,2例明显缓解。 3例癌热治疗后均消失。 13例治疗后食纳改善 ,体重不同程度增加。 9例AFP阳性 ,治疗后恢复正常 4例 ,2例明显下降 ,3例无变化。影像学改变 :肿块缩小 ,内部回声增强 ,血流减少 ,液化区形成。组织学变化 :肿瘤组织液化坏死 ,癌细胞变性 ,血管闭塞 ,不同程度纤维组织增生。毒副反应轻 ,无严重不良反应。结论 本法操作简便安全 ,毒副反应轻 ,抗肿瘤效果显著。
Objective To observe the effect of ultrasound-guided direct interventional chemotherapy for hepatocellular carcinoma. Methods Ultrasound-guided liver puncture and direct interventional chemotherapy was used to treat 20 cases of liver cancer. There were 14 cases of primary liver cancer and 6 cases of metastatic liver cancer. There were 4 cases in stage I, 12 cases in stage II, and 4 cases in stage III. The drugs were pirarubicin (THP) 40-60 mg/m2, MMC 4- 10 mg, and carboplatin 400 mg/m2, diluted to 10-30 ml once every 3 weeks and three times for 1 course of treatment, a total of 128 cases. The results were partial remission (PR) in 15 patients, stable (NC) in 2 patients, and deterioration in (PD) in 3 patients. Four patients underwent surgical resection. After treatment of liver pain in 14 cases, 12 cases completely disappeared and 2 cases significantly relieved. All 3 cases disappeared after cancer heat treatment. After 13 treatments, food intake improved, and body weight increased in different degrees. Nine cases of AFP were positive, 4 cases returned to normal after treatment, 2 cases decreased significantly, and 3 cases did not change. Imaging changes: reduced size, enhanced internal echo, decreased blood flow, and liquefaction zone formation. Histological changes: tumor tissue liquefaction and necrosis, cancer cell degeneration, vascular occlusion, varying degrees of fibrous tissue hyperplasia. The toxicity was mild and there were no serious adverse reactions. Conclusion This method is simple and safe to operate, with mild side effects and significant anti-tumor effects.