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目的 :采用氩氦刀经皮穿刺冷冻配合中药及全身化疗治疗失去手术切除机会的中晚期肝癌 ,探求治疗中晚期肝癌的新手段。方法 :①氩氦刀治疗 :刀尖温度达零下130 -零下150℃ ,持续15-20min,热融温度升至20-30℃ ,重复一次。术后患者定期复查AFP ,CEA ,B超 ,CT或MRI。②中药治疗 :自拟抗癌方水煎服,日1剂,15天为一疗程。③化疗 :健择1.0-1.6gd1d8,草铂100-200mgd1,外周静脉滴注 ,28天为1周期 ,共4-6周期。结果 :45例肝癌患者接受治疗 ,CT及B超影像能显示术中病灶受到冷冻的范围及术后病灶的改变情况 ,全组无手术死亡 ,无胆瘘、大出血、伤口感染、肝破裂及穿刺道转移等并发症 ,AFP值在治疗后有所降低 ,术后有短暂肝功能损害和低热 ,5例患者出现反应性右侧胸腔积液 ,1例术后出现穿刺针道慢性渗血 ,多数患者治疗后短期内生活质量有所提高。结论 :氩氦刀经皮冷冻配合中药及全身化疗治疗中晚期肝癌 ,创伤微、并发症少、安全性高、疗效可靠 ,是中晚期肝癌综合治疗的一种新方法。远期疗效尚有待观察。
OBJECTIVE: To study the new treatment of advanced hepatocellular carcinoma (HCC) by using argon-helium knife percutaneous puncture and cryotherapy combined with traditional Chinese medicine and systemic chemotherapy in the treatment of advanced hepatocellular carcinoma (LOHC) which lacks the chance of surgical resection. Methods: ① argon-helium knife treatment: tip temperature of minus 130 - minus 150 ℃ for 15-20min, hot melt temperature rose to 20-30 ℃, repeated. Postoperative patients regularly review AFP, CEA, B ultrasound, CT or MRI. ② Chinese medicine treatment: self-designed anti-cancer decoction, day 1, 15 days for a course of treatment. ③ chemotherapy: Gentle 1.0-1.6gd1d8, Platinum 100-200mgd1, peripheral intravenous drip, 28 days for a cycle, a total of 4-6 cycles. Results: Forty-five patients with liver cancer were treated. CT and B-scan images showed the extent of intraoperative frozen lesions and postoperative lesions. There was no operative mortality, no biliary fistula, massive bleeding, wound infection, rupture of liver and puncture Tract complications such as AFP decreased after treatment, postoperative transient liver damage and fever, 5 cases of patients with reactive right pleural effusion, puncture needle puncture occurred in 1 case of chronic bleeding, the majority of Shortly after the patient’s quality of life has improved. Conclusion: Argon-helium knife percutaneous freezing with traditional Chinese medicine and systemic chemotherapy in the treatment of advanced liver cancer, micro-trauma, less complications, high safety, efficacy and reliable, is a new method of comprehensive treatment of advanced liver cancer. Long-term efficacy remains to be seen.