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目的观察肝动脉化疗栓塞术(TACE)联合125I粒子植入治疗晚期肝癌的疗效。方法TACE采用seldinger技术经皮股动脉穿刺,引入5F肝管或cobra导管插入肝动脉和肠系膜上动脉造影了解肿瘤大小,部位,血供及门脉有无瘤栓等情况。结果13例患者肿瘤明显缩小,缩小程度3～5cm,3例瘤体无明显变化。12例AFP升高患者,术后1、3、6个月复查逐渐下降,其中3例转阴。存活2年以上者5例,1.5年以上者9例,2例分别与术后7个月、9个月因全身衰竭死亡。结论TACE仍然是治疗不适宜手术切除的原发性肝癌的首选方法。
Objective To observe the effect of hepatic arterial chemoembolization (TACE) combined with 125I seed implantation in the treatment of advanced hepatocellular carcinoma. Methods TACE was performed using seldinger technique and percutaneous femoral artery puncture. 5F hepatic duct or cobra catheter was inserted into the hepatic artery and superior mesenteric arteriography. Tumor size, location, blood supply and portal vein tumor thrombus were observed. Results The tumors of 13 patients were significantly reduced and the degree of reduction was 3 to 5 cm. There was no significant change in the tumor in 3 cases. Twelve patients with elevated AFP were gradually reduced after 1, 3, and 6 months of follow-up, of whom 3 were negative. Five patients survived more than two years, nine patients over 1.5 years, and two patients died of systemic failure 7 months and 9 months after surgery. Conclusions TACE is still the preferred method for the treatment of primary liver cancer that is not suitable for surgical resection.