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目的评价肝动脉化疗栓塞(TACE)联合门静脉栓塞(PVE)术对非栓塞肝容积的影响。方法21例肝癌患者行TACE后,分别实施门静脉亚段分支(亚段组)、段分支(段组)以及叶分支(叶组)PVE。其中亚段组5例,段组10例,叶组6例(均为肝右叶)。所有患者于PVE前及术后4周均行肝脏CT扫描检查,分别测量肝脏病变区和非栓塞区容积,观察非栓塞肝脏的容积变化。结果非栓塞肝容积的变化与栓塞肝容积显性相关(r=0.752,P<0.01)。亚段组非栓塞肝容积增加率为(2.4±2.7)%,段组为(11.4±6.7)%(P<0.05)以及叶组为(39.8±19.9)%(Ρ<0.01)。结论肝动脉化疗栓塞联合门静脉栓塞术能安全有效地增加非栓塞肝的容积,为肝癌扩大肝切除术的实施提供了一种切实可行的选择。
Objective To evaluate the effect of transcatheter arterial chemoembolization (TACE) combined with portal vein embolization (PVE) on non-occlusive liver volume. Methods Twenty-one patients with hepatocellular carcinoma undergoing TACE were performed the portal vein sub-segment (sub-segment), segment branch (segment) and leaf branch (leaf) PVE. There were 5 cases in the subgroup, 10 cases in the segment group and 6 cases in the leaf group (all were right lobe). All patients underwent liver CT scanning before PVE and 4 weeks after operation. The volume of liver lesion and non-embolic area were measured and the volume of non-embolic liver was observed. Results The change of non-embolic volume was significantly correlated with the volume of embolic liver (r = 0.752, P <0.01). The volume of non-embolized liver volume increased by (2.4 ± 2.7)% in the sub-group, (11.4 ± 6.7)% in the segment group and (39.8 ± 19.9)% in the leaf group (P <0.01). Conclusion Transcatheter arterial chemoembolization combined with portal vein embolization can safely and effectively increase the volume of non-embolized liver, providing a feasible option for the implementation of hepatic resection of liver cancer.