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目的探讨在肝癌的介入治疗中复合型栓塞剂的价值。方法将原发性肝癌患者188例分为常规组103例,复合组85例。观察并比较两组的碘油沉积、有效率、手术切除、病理改变、生存率和并发症。结果在巨块型、结节型的多血供肝癌患者中,碘油沉积表现为完全填充型和致密型。常规组和复合组碘油沉积分别为59.2%和89.4%;有效率(CR+PR)两组分别为32.0%和56.5%;手术切除率分别为5.8%和15.3%;肿瘤完全坏死率分别为1.0%和4.7%。常规组1,2,3年生存率分别为57.7%、42.8%和8.4%,复合组1,2,3年生存率分别为79.8%、55.3%和38.5%,两组比较,差异有统计学意义。并发症两组间基本相同。结论肝癌患者的介入治疗疗效与栓塞剂的用量及种类相关。对于巨块型、结节型的多血供肝癌患者,应提倡超选择复合栓塞治疗;少血供、弥漫型和不能超选择插管的肝癌患者应常规治疗。
Objective To investigate the value of compound embolic agents in the interventional treatment of liver cancer. Methods 188 patients with primary liver cancer were divided into conventional group of 103 cases and compound group of 85 cases. Lipiodol deposition, efficiency, surgical resection, pathological changes, survival rate and complications were observed and compared between the two groups. Results In the massive, nodular, multi-donor liver cancer patients, lipiodol deposition showed complete filling and densification. Conventional and compound lipiodol deposition rates were 59.2% and 89.4% respectively; CR + PR were 32.0% and 56.5% respectively; Surgical resection rates were 5.8% and 15.3% respectively; complete tumor necrosis rates were 1.0% and 4.7%. The 1, 2, 3-year survival rates of the conventional group were 57.7%, 42.8% and 8.4% respectively, and the 1-, 2- and 3-year survival rates of the composite group were 79.8%, 55.3% and 38.5%, respectively significance. Complications were basically the same between the two groups. Conclusion The efficacy of interventional therapy in patients with liver cancer is related to the dosage and type of embolic agent. For bulky, nodular blood supply of patients with liver cancer, should be super-selective compound embolization should be advocated; less blood supply, diffuse and can not be super-selective intubation of liver cancer patients should be treated routinely.