目的探讨肝动脉化疗栓塞(TACE)联合经皮穿剌瘤内碘油化疗乳剂(CALE)注射治疗中晚期肝癌的疗效。方法选择56例TACE术后碘油沉积不全的中晚期肝癌患者随机分为两组,26例TACE联合经皮穿剌瘤内CALE注射治疗为研究组,30例重复TACE治疗为对照组,疗程结束后查肝脏CT、彩超、AFP测定,比较两组的肿瘤缩小程度、肿瘤血供减少情况、AFP变化及随访一年生存率。结果研究组总有效率、AFP平均下降率及肿瘤血供减少率分别为76.92%,78.26%,92.3%;均高于对照组的43.33%,45.83%,63.33%(P<0.05)。研究组一年生存率为96.15%,对照组一年生存率为86.67%,两组差异无统计学意义(P>0.05)。研究组患者未发生严重并发症。结论 TACE联合经皮穿剌瘤内CALE注射治疗中晚期肝癌的疗效优于单纯的TACE治疗,且经皮穿剌注药术是安全和有效的。 Objective To investigate the efficacy of transcatheter arterial chemoembolization (TACE) and percutaneous intraepithelial instillation of lipiodol emulsion (CALE) in the treatment of advanced hepatocellular carcinoma. Methods Sixty-six patients with advanced hepatocellular carcinoma with incomplete lipiodol deposition after TACE were randomly divided into two groups. Twenty-six TACE combined with percutaneous intracranial instillation of CALE injection was used as the study group, and 30 patients with repeated TACE as control group. After checking the liver CT, color Doppler ultrasound, AFP determination, the two groups compared the degree of tumor reduction, tumor blood supply reduction, AFP changes and follow-up one-year survival rate. Results The total effective rate, average AFP rate and tumor blood supply reduction rate in the study group were 76.92%, 78.26% and 92.3%, respectively, which were higher than those in the control group (43.33%, 45.83%, 63.33%, P <0.05). The one-year survival rate was 96.15% in the study group and one-year survival rate in the control group was 86.67%. There was no significant difference between the two groups (P> 0.05). Study group patients did not occur serious complications. Conclusion TACE combined percutaneous intracranial instillation of CALE injection in the treatment of advanced liver cancer is better than the simple TACE treatment, and percutaneous puncture injection is safe and effective.