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目的:探讨综合性超声介入疗法对中晚期肝癌的疗效。方法:50例经活检证实的肝癌依据肿瘤的大小和数目分为:一组,肿块直经<3.0cm,个数<2个。二组:肿块直径3.1~5.0cm,个数<2个。三组:肿块直径>5.0cm,个数≥1。超声引导下经皮经肝穿刺肿瘤,分别采用单纯微波热凝(PMCT)(方案1a)、或单纯无水乙醇肿瘤间质内注射(PEIT)(方案1b)、微波热凝+无水乙醇肿瘤间质内注射(方案2)、微波热凝+无水乙醇肿瘤间质内注射+门(脾)静脉穿刺灌注化学药物(方案3),不同的介入治疗方法。治疗后定期行超声、CT、肝穿活检、随访观察其疗效并加以比较。随访时间10个月至5年。结果:直经<3.0cm,个数<2个小肝癌单纯微波热凝和单纯无水乙醇注射1、23、、年生存率无差异。肿块直经3.0~5.0cm者方案2优于方案1a、1b。肿块>5.0cm多结节肝癌或伴门脉癌栓者,方案3优于方案2。综合性介入治疗肝癌的总有效率均高于方案1a和方案1b。结论:该方案设计合理,疗效确切,操作便利,安全可靠,费用低,值的推广。
Objective: To investigate the effect of comprehensive ultrasonic interventional therapy on advanced liver cancer. Methods: Fifty cases of liver cancer confirmed by biopsy were divided into two groups according to the size and number of the tumor: one group, the mass was less than 3.0cm and the number was less than two. Two groups: mass diameter 3.1 ~ 5.0cm, the number of <2. Three groups: mass diameter> 5.0cm, the number of ≥ 1. Ultrasound-guided percutaneous transhepatic neoplasms were treated with microwave coagulation alone (PMCT) (protocol 1a) or pure ethanol injection (PEIT) (protocol 1b), microwave thermocoagulation + absolute ethanol tumor Interstitial injection (Scheme 2), microwave thermocoagulation + ethanol-injected tumor interstitial injection + portal (spleen) venous perfusion chemotherapy (Option 3), different interventional methods. After treatment regularly ultrasound, CT, liver biopsy, follow-up to observe its efficacy and to be compared. Follow-up time ranged from 10 months to 5 years. Results: There was no difference in the annual survival rate between simple microwave coagulation and simple ethanol injection with a diameter of <3.0cm and <2 small hepatocellular carcinoma. Mass directly through the 3.0 ~ 5.0cm program 2 is better than the program 1a, 1b. Tumors> 5.0cm multi-nodular hepatocellular carcinoma or portal vein thrombosis, program 3 is better than program 2. The total effective rate of comprehensive interventional treatment of hepatocellular carcinoma was higher than that of scheme 1a and 1b. Conclusion: The scheme is reasonable in design, effective in curative effect, convenient in operation, safe and reliable, low in cost and promotion in value.