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目的 评价术前应用超常规剂量碘油超选择TAE与常规TAE治疗原发性肝癌的价值。方法 1987年 8月～ 1999年 12月 12年间 2 7例原发性肝癌分为两组 :治疗组 17例 ,应用常规导管或球囊导管超选择至肿瘤供血动脉 ,阻断其血流 ,使注射碘油时不产生逆流 ,将全部动脉肿瘤血管、病变周围正常的小动脉及肝实质和门静脉分支栓塞 ,栓后2 5天～ 12 1天手术切除 ;对照组 10例 ,应用一般导管 ,常规剂量的碘油超选或不超选栓塞肿瘤供血动脉 ,栓后 2 0天～14 0天手术切除。对两组病人切除的标本均进行了详细的病理学研究 ,同时对全部病人随访 3～ 8年。结果 治疗组 17例中 11例肿瘤 10 0 %坏死 ,其余 6例坏死率为 85 %～ 95 % ,3、5年生存率分别为 88.2 % (15 /17)、45 .5 % (5 /11) ,3例现生存 6～ 8年 ;对照组 10例中 2例肿瘤完全坏死 ,另 8例坏死率为 75 %～ 95 % ,3、5年生存率分别为 60 .0 % (6/10 )、14 .3 % (1/7)。结论 术前应用超常规剂量碘油超选择TAE治疗原发性肝癌效果明显好于常规TAE。
Objective To evaluate the value of preoperative super-selected lipiodol superselect TAE and routine TAE in the treatment of primary liver cancer. Methods From August 1987 to December 1999, twenty-seven cases of primary liver cancer were divided into two groups: 17 cases in the treatment group. Conventional catheters or balloon catheters were used to select the tumor supplying arteries to block the blood flow. No countercurrent was generated when iodized oil was injected. All arterial tumor vessels, normal arterioles surrounding the lesions, and hepatic parenchymal and portal vein branches were embolized. Surgical resection was performed 25 days to 12 days after suppository; 10 cases in the control group were treated with general catheters. Dosage of lipiodol was over or not selected for embolization of the tumor supplying artery, and surgical removal was performed 20 days to 14 days after suppository. Detailed pathological studies were performed on the specimens removed from the two groups of patients. All patients were followed up for 3 to 8 years. Results Among the 17 patients in the treatment group, 11 cases had necrosis in 100% of tumors, and the remaining 6 cases had necrotic rates of 85% to 95%. The 3 and 5 year survival rates were 88.2% (15/17) and 45.5% (5/11) respectively. ), 3 cases survived for 6 to 8 years; in the control group, 2 cases had complete tumor necrosis, 8 cases had 75% to 95% necrosis, and 3 and 5 year survival rates were 60.0 % (6/10). ), 14.3% (1/7). Conclusion The preoperative application of supernormal dose of iodine oil superselective TAE for treatment of primary liver cancer was significantly better than conventional TAE.