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目的 探讨肝脏转移瘤经导管药盒植入系统 (PCS)介入化疗的可行性、临床疗效、并发症及处理。方法 经股动脉穿刺植入PCS至肝靶血管 ,经 PCS化疗灌注和 (或 )化疗栓塞治疗 41例 ,其中结肠癌肝转移 18例 ,鼻咽癌肝转移 11例 ,直肠癌肝转移 7例 ,胃癌肝转移 5例 ,每 4～ 6周为一疗程。结果 治疗后生存期 6～ 2 1月 ,中位生存期 13个月 ,有效率 (CR+ PR) 6 8.3% (2 8/41)。并发症包括 :留置管滑脱至主动脉 3例 ;留置管移位至胆管 2例 ;切口裂开 1例 ;药盒植入部位组织坏死 1例。皆未发生感染、出血等并发症及导管堵塞现象。结论 经 PCS对肝脏转移瘤进行介入化疗安全、有效。
Objective To investigate the feasibility, clinical efficacy, complications and management of hepatic metastases via catheterization and PCS implantation. Methods PCS was implanted into the target liver vessel via femoral artery puncture. 41 cases were treated with chemotherapy and chemoembolization by PCS, including 18 cases of liver metastasis of colon cancer, 11 cases of liver metastasis of nasopharyngeal carcinoma, 7 cases of hepatic metastasis of rectal cancer, Liver metastases of gastric cancer in 5 cases, every 4 to 6 weeks for a course of treatment. Results The survival time was 6 ~ 21 months after treatment. The median survival time was 13 months. The effective rate (CR + PR) was 8.3% (28/41). Complications included: 3 cases of indwelling slippage to the aorta; 2 cases of indwelling tube translocation to the bile duct; 1 case of incision rupture; 1 case of tissue necrosis of the implantation site. None of the infections, bleeding and other complications and catheter blockage phenomenon. Conclusions PCS is safe and effective for interventional chemotherapy of liver metastases.