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目的初步探讨超声介导聚桂醇联合无水乙醇治疗肝细胞癌(HCC)伴发不同分型门静脉癌栓(PVTT)的临床应用价值。方法对41例HCC伴不同分型PVTT患者行超声介导聚桂醇联合无水乙醇治疗,每周1~2次。疗程结束后两周行彩色多普勒超声检查,观察PVTT的大小、内部回声及血流变化,以及外周血检甲胎蛋白(AFP),统计近期疗效及1、2、3年生存率。结果 41例PVTT患者治疗后主要表现为癌栓停止发展或缩小、癌栓内搏动性血流信号消失及AFP不同程度的下降,近期疗效达87.8%(35/41),1、2、3年生存率分别为70.7%、46.3%、29.3%,分型越低者生存时间越长。结论超声介导聚桂醇联合无水乙醇治疗HCC伴PVTT抑瘤镇痛效果好,能提高患者近期疗效和生存率。
Objective To investigate the clinical value of ultrasound-mediated intracellular fusion of alcohol and alcohol in the treatment of hepatocellular carcinoma (HCC) with different types of portal vein tumor thrombus (PVTT). Methods 41 cases of HCC with different type PVTT patients underwent ultrasound-mediated intracellular alcohol and ethanol combination of alcohol, 1 or 2 times a week. Color Doppler echocardiography was performed two weeks after the end of treatment. The size of PVTT, internal echo and blood flow, as well as AFP in peripheral blood were measured. The short-term efficacy and 1, 2, 3 year survival rate were also observed. Results The results of 41 patients with PVTT after treatment showed that the development of thrombus stopped or reduced, the signal of thrombosis inside the tumor thrombus disappeared and AFP decreased to some extent. The short-term efficacy was 87.8% (35/41), 1, 2, 3 years Survival rates were 70.7%, 46.3%, 29.3%, the lower the type of survival longer. Conclusion Ultrasound-mediated intraperitoneal injection of alcohol and ethanol combined with absolute ethanol inhibits tumor and analgesic effect of HCC with PVTT, which can improve the short-term efficacy and survival rate of patients.