目的探讨原发性肝癌(HCC)合并门静脉癌栓(PVTT)的外科治疗效果。方法 63例肝癌合并门静脉癌栓患者中,17例(A组)行肝癌切除加门静脉癌栓取栓术,术后再加大网膜静脉双插管灌注化疗;其余46例(B组)行非手术治疗,包括射频治疗24例、无水酒精注射14例、介入治疗8例。结果 A组术后1、2和3年的生存率分别为65.2%、41.2%、23.5%,明显高于B组的45.7%、28.3%和0%(P<0.05)。结论与非手术治疗比较,手术治疗能相对延长肝癌合并门静脉癌栓患者的生存时间,方便术后使用大网膜静脉插管灌注化疗。 Objective To investigate the surgical treatment of primary hepatic carcinoma (HCC) combined with portal vein tumor thrombus (PVTT). Methods Totally 63 cases of hepatocellular carcinoma with portal vein tumor thrombus were treated by hepatectomy plus portal vein tumor thrombus and embolization in 17 cases (group A). ​​The other 46 cases (group B) Non-surgical treatment, including radiofrequency 24 cases, 14 cases of anhydrous alcohol injection, interventional therapy in 8 cases. Results The survival rates at 1, 2 and 3 years after operation in group A were 65.2%, 41.2% and 23.5%, respectively, which were significantly higher than those in group B (45.7%, 28.3% and 0%, P <0.05). Conclusion Compared with non-surgical treatment, surgical treatment can relatively extend the survival time of hepatocellular carcinoma patients with portal vein tumor thrombus and facilitate the use of intravenous infusion of epidural catheter after chemotherapy.