摘要
目的报道两种针对肝癌门静脉癌栓的治疗技术,并比较其疗效。方法本研究共纳入162例肝癌合并门脉癌栓的患者。治疗组中80例患者在经肝动脉插管化疗栓塞术(TACE)基础上接受了直接微波消融术、射频消融等治疗方案,对照组82例患者仅接受TACE术。结合文献报道及医疗实践,我们探讨了合理的标准手术流程并分析了临床结果。结果未观察到严重并发症。术后3个月时复查肝脏增强MRI显示5例(6.2%)患者静脉癌栓完全消失,14例(17.5%)患者静脉癌栓明显缩小,43例(53.8%)静脉癌栓稳定,18例(22.5%)静脉癌栓进展。治疗组门静脉癌栓进展显著慢于对照组(P<0.001)。结论直接微波消融术用于肝内段门静脉癌栓,经皮肝穿刺门静脉消融导管术用于肝外段门静脉癌栓上较为安全有效。
Objective To introduce two treatment techniques for portal vein tumor thrombus of hepatocellular carcinoma （HCC） , and to compare their curative effects. Methods A total of 162 HCC patients with portal vein tumor thrombus were included in this study. After having transcatheter arterial chemoembolization （ TACE ）, patients of the study group （ n = 80 ） received additional direct percutaneous microwave ablation （PMWA）, radiofrequency catheter ablation, and other therapies; while patients of the control group （n= 82） received TACE only. Combined with literature reports and medical practice, the reasonable standard operation procedure was discussed and the clinical results were analyzed. Results No severe complications were observed. Contrast-enhanced MRI performed at 3 months after the treatment showed that complete disappearance of portal vein tumor thrombus was achieved in 5 patients （ 6.2% ） and obvious shrinkage of portal vein tumor thrombus in 14 patients （ 17.5%）, stable portal vein tumor thrombus was seen in 43 patients （53.8%） and progression of portal vein tumor thrombus in 18 patients （22.5%）.The progression of portal vein tumor thrombus in the study group was significantly slower than that in the control group （ P〈0.001 ）. Conclusion It is safer and more effective to use direct percutaneous microwave ablation for portal vein tumor thrombus within intrabepatic segment and to use pereutaneous liver puncture portal catheter radiofrequency ablation for portal vein tumor thrombus within extrahepatic segment.
出处
《介入放射学杂志》
CSCD
北大核心
2016年第6期510-514,共5页
Journal of Interventional Radiology
基金
国家自然科学基金(81301302)
上海市科委医学引导类科技项目(15411966100)
上海市市级医院新兴前沿技术联合攻关项目(SHDC12014112)
关键词
射频消融
肝癌
门静脉癌栓
radiofrequency ablation
hepatocellular carcinoma
portal vein tumor thrombus
