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目的 研究超声引导下经皮门静脉穿刺注药治疗肝癌的应用价值 ,旨在提高肝动脉栓塞化疗的疗效和降低肝癌合并门静脉转移率。方法 对 14例不能手术的肝癌患者在行肝动脉栓塞治疗 1周后 ,超声引导下经皮门静脉穿刺注药化疗 ,化疗药为顺铂 30 mg,5 - Fu 5 g。结果 (1)治疗后所有患者的肿块均有明显缩小 ,其中3例缩小 >4 0 % ;(2 )肝癌合并门静脉癌栓患者 6例 ,门静脉癌栓消失率为 16 .7% (1/ 6 ) ,缩小率为 5 0 % (3/ 6 ) ,无变化 33% (2 / 6 ) ;(3)治疗后 10例原发性肝癌 AFP升高者 ,7例下降超过 5 0 % ,2例无变化 ,1例升高 ;(4)患者腹胀减轻 ,腹水减少。结论 超声引导下经皮门静脉穿刺注药治疗 ,确实有效 ,方法简便、安全 ,无并发症 ,作为肝癌综合治疗的方法之一 ,值得进一步探索。
Objective To study the value of ultrasound-guided percutaneous portal vein puncture in the treatment of liver cancer, and to improve the curative effect of hepatic arterial chemoembolization and reduce the rate of hepatocellular carcinoma with portal vein metastasis. Methods One hundred and fourteen patients with inoperable liver cancer undergoing transcatheter arterial chemoembolization under the guidance of ultrasound were treated with transcatheter arterial chemoembolization for one week. The chemotherapeutic agents were cisplatin 30 mg and 5 - Fu 5 g. Results (1) After treatment, the mass of all patients were significantly reduced, of which 3 cases were reduced> 40%; (2) 6 cases of hepatocellular carcinoma with portal vein tumor thrombus and 16.7% ), The reduction rate was 50% (3/6), no change 33% (2/6); (3) 10 cases of primary liver cancer AFP increased after treatment, 7 cases decreased more than 50%, 2 cases No change, 1 case increased; (4) patients with abdominal distension reduced ascites decreased. Conclusion Ultrasound-guided percutaneous portal vein puncture injection therapy is indeed effective, the method is simple, safe, and no complications, as one of the comprehensive treatment of liver cancer, it is worth further exploration.