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目的 探讨原发性肝癌 (PHC)病灶在不同切除方式时化疗泵埋 (DDS)置途径的选择。方法 将 190例原发性肝癌患者按手术切除方式分为原发肿瘤完整切除 (A)、未完全切除 (B)组两组。再根据肿瘤不同切除方式时所采用置泵途径 ,两大组各分为经肝动脉 +门静脉双途径置泵 (a)组、经门静脉 (b)组、经肝固有动脉 (c)三组。结果 (1)A组中 ,c组的 1年、3年复发率均高于b组 ;a组的 1年、3年复发率与b组无差异。b组与a、c两组相比 ,其生存率与a组无明显差异 ,较c组生存率高。 (2 )B组中 ,a组的 1年、3年生存率与b组有显著差别 ;c组预后差于a组 ,但与b组无差别。结论 在原发肿瘤完整切除的情况下 ,首选经门静脉置泵 ;在原发肿瘤未能完整切除的患者 ,只能选择双途径置泵。
Objective To investigate the choice of pathways for primary hepatic carcinoma (PHC) implantation in patients undergoing PHD with different excision modalities. Methods 190 cases of primary liver cancer patients were divided into primary tumor resection (A) and incomplete resection (B) according to surgical resection. Then according to different tumor removal methods used by the pump approach, the two groups were divided into hepatic artery + portal vein dual-channel pump (a) group, the portal vein (b) group, the hepatic artery (c) three groups. Results (1) In group A, the recurrence rates at 1 year and 3 years in group C were higher than those in group b; The recurrence rates at 1 year and 3 years in group a were not different from those in group b. Compared with group a and group b, there was no significant difference in survival between group b and group a, and the survival rate was higher than group c. (2) In group B, the 1-year and 3-year survival rates of group a were significantly different from those of group b; the prognosis of group c was worse than group a but no difference with group b. Conclusion In the case of primary tumor complete resection, the first choice of portal vein pump; failed primary resection in patients with primary tumors, only the choice of dual-channel pump.