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自1983年NakakamaK等首先报道经肝动脉灌注(TAI)抗癌药物治疗肝癌以来,肝癌的介人治疗进展很快,特别是经肝动脉栓塞(TAE)联合化疗已日益广泛用于肝癌的治疗,并取得了较好的临床效果.随着医学影像学的发展,小肝癌相继被发现,使外科手术变得相对容易和安全,但术后短期内肝内复发仍是十分严重的问题,Sasaki、Belghiti和Masahiro等报道其手术后复发率分别高达47、60和 56·6%.介入治疗因其相对安全、有效、创伤小、痛苦少而备受青睐.现就其主要方面综述如下.1 肝癌介入治疗的理论基础正常肝脏的血供20%～25%来自肝动脉.75%～80%来自门静脉,而肝癌则主要以肝动脉供血,门静脉供血较少,对于有包膜的肝癌则完全由肝动脉供血.亦即大多数肝癌为双重血供,肿瘤的中心部分由肝动脉供血,而肿瘤与肝实质交界的部分(即肿瘤的周边)由门脉供血.因而TAE后,肿瘤中央部血供已被阻断,肿瘤大部分坏死.如联合门脉栓塞(PVE),理论上肿瘤将完全坏死.
Since 1983, Nakakama K et al. first reported that hepatic arterial infusion (TAI) anticancer drugs have been used to treat liver cancer. The intervention of liver cancer has progressed rapidly, and hepatic artery embolization (TAE) combined with chemotherapy has been increasingly used for the treatment of liver cancer. And has achieved good clinical results. With the development of medical imaging, small hepatocellular carcinoma has been found one after another, making surgery relatively easy and safe, but intrahepatic recurrence in the short term is still a very serious problem, Sasaki, Belghiti and Masahiro reported that the recurrence rate after surgery was as high as 47, 60, and 56.6%, respectively. Interventional treatment was favored because of its relatively safe, effective, less invasive, and less painful. The major aspects are summarized below.1 Liver cancer The theoretical basis of interventional therapy Normal blood supply from the liver 20% to 25% from the hepatic artery. 75% to 80% from the portal vein, while liver cancer is mainly in the hepatic artery, portal vein blood supply is less, for the coated liver cancer is completely Hepatic artery blood supply. That is, most liver cancers have dual blood supply. The central part of the tumor is supplied by the hepatic artery, and the part of the tumor that interfaces with the liver parenchyma (ie, the periphery of the tumor) is supplied by the portal vein. Therefore, after the TAE, the tumor center blood Forex Blocking tumor necrosis most as joint portal embolization (PVE), in theory, it will complete tumor necrosis.