论文部分内容阅读
目的探讨CT导引瘤内注射乙酸治疗原发性肝癌的疗效。方法2001年2月-2006年10月在CT导引下直接瘤内注射乙酸治疗原发性肝癌患者46例(病灶61个)病灶,其中肿瘤直径≤3 cm者14个,3 cm<直径≤5 cm者36个,直径>5 cm者11个,多发肿瘤者10例(2~4个)。46例61个肿瘤CT导引PAI治疗145次。随访时间5~48个月,多次复查CT,动态观察肿瘤坏死情况,记录HCC患者的临床资料、存活时间、肝肾功能、AFP值等。结果46例61个肿瘤145次穿刺成功率100%;肿瘤坏死率为71%~100%;直径≤3 cm的小肝癌1、2、3、4年的生存率分别为100%(12/12)、92%(11/12)、83%(10/12)、67%(8/12)(P<0.05);3 cm<直径≤5 cm者1、2、3、4年的生存率分别为89%(24/27)、78%(21/27)、67%(18/27)、44%(12/27)(P<0.05);直径>5 cm者1、2年的生存率分别为29%(2/7)、14%(1/7)(P<0.05)。主要并发症为局限性腹膜炎、化学性胸膜炎(少量胸腔积液)、气胸,无严重的不良反应和并发症。结论CT引导下经皮穿刺直接瘤体内注射乙酸治疗单结节、无转移的小肝癌是一种疗效可靠、经济实用的微创性治疗技术。
Objective To investigate the curative effect of CT guided tumor injection of acetic acid in the treatment of primary liver cancer. Methods From February 2001 to October 2006, 46 cases (61 lesions) of primary liver cancer were treated with direct intratumoral injection of acetic acid under the guidance of CT. There were 14 tumors with a diameter of ≤3 cm, a diameter of ≤3 cm 36 with 5 cm, 11 with diameter> 5 cm and 10 with multiple tumors (2 ~ 4). 46 cases of 61 tumor CT guided PAI treatment 145 times. The follow-up time ranged from 5 to 48 months. The patients underwent CT examination repeatedly to observe the tumor necrosis and record the clinical data, survival time, liver and kidney function, AFP value of HCC patients. Results The success rate of puncturing 145 lesions in 46 cases was 100%. The tumor necrosis rate was 71% -100%. The survival rates at 1, 2, 3, 4 years of small hepatocellular carcinoma with diameter less than 3 cm were 100% (12/12 ), 92% (11/12), 83% (10/12), 67% (8/12) (P <0.05). The survival rates of 1, 2, 3 and 4 years Respectively, were 89% (24/27), 78% (21/27), 67% (18/27), 44% (12/27) (P <0.05) Rates were 29% (2/7) and 14% (1/7), respectively (P <0.05). The main complications were localized peritonitis, chemical pleurisy (a small amount of pleural effusion), pneumothorax, no serious adverse reactions and complications. Conclusion CT-guided percutaneous direct injection of acetic acid in the treatment of single nodular non-metastatic small hepatocellular carcinoma is a reliable, economical and practical minimally invasive treatment technology.