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目的:探讨介入治疗肝癌合并门脉一级分支和或门脉主干癌栓的适应证和治疗方法。方法:25例原发性肝癌合并门脉一级分支和(或)门脉主干癌栓患者接受动脉化疗栓塞术(TACE),部分患者同时接受门脉支架置放术。结果:25例患者分别接受TACE术1～4次,共46次,5例患者放置门脉支架。术后1周Child-Pugh分级11例次由术前A级升至B级,2例次由B级升至C级,1例次由A级升至C级。1例次术后第2天出现肝性脑病。1例患者未完成门脉支架随访、其余4例至患者死亡时支架仍保持通畅。1例患者于6个月失访,其余24例生存期3～15个月,平均6.4个月。结论:TACE和门脉支架置放治疗肝癌合并门脉一级分支和(或)门脉主干癌栓是安全有效的方法,但必须严格掌握适应证和治疗方法。
Objective: To investigate the indications and treatment of interventional treatment of primary hepatic carcinoma with portal vein thrombosis and portal vein thrombosis. Methods: Twenty - five patients with primary hepatic carcinoma with portal vein primary branch and / or portal vein tumor thrombus received TACE, and some patients received portal stent placement simultaneously. RESULTS: Twenty-five patients underwent TACE for 1 to 4 times respectively for 46 times, and 5 patients underwent portal stent placement. One week after operation, Child-Pugh’s grade increased from Grade A to Grade B, Grade B to Grade C in two cases and Grade A to Grade C in one case. One case had hepatic encephalopathy on the second day after operation. One patient did not complete portal stent follow-up. The remaining four patients remained unobstructed when the patient died. One patient was lost at 6 months and the remaining 24 patients survived for 3-15 months with an average of 6.4 months. Conclusion: TACE and portal stent placement for the treatment of hepatocellular carcinoma with primary portal vein branches and / or portal vein tumor thrombus is a safe and effective method, but indications and treatment methods must be strictly controlled.