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目的 :探讨不规则性肝癌切除术联合肝血管插管栓塞化疗的疗效及影响生存因素。方法 :将 1991年 1月～ 2 0 0 1年1月间 6 8例肝癌行不规则性肝癌切除术联合肝血管插管栓塞化疗为观察组 ,将同期 6 3例肝癌行不规则性肝癌切除术联合外周静脉滴注化疗为对照组。结果 :观察组一、二、三年生存率分别为 86 8%、47 1%、35 3% ;对照组一、二、三年生存率分别为5 2 4%、2 8 6 %、14 3%。碘油沉积好的 5 3例一、二、三年生存率分别为 90 6 %、73 6 %、6 2 3% ,较碘油沉积差 15例的生存率(一、二、三年生存率分别为 46 7%、2 6 7%、13 3% )高。无门静脉癌栓者 6 2例一、二年生存率分别为 85 5 %、6 9 4% ,有门静脉癌栓者 6例 ,一、二年生存率分别为 33 3%、0 0 %。结论 :不规则性肝癌切除术联合肝血管插管栓塞化疗是治疗肝癌的有效方法 ,远期疗效明显优于不规则性肝癌切除术联合外周静脉滴注化疗。门静脉是否有癌栓、碘油沉积情况是影响疗效的主要因素。
Objective: To investigate the curative effect and survival factors of irregular hepatic cancer resection combined with hepatic artery embolization and chemotherapy. Methods: From January 1991 to January 2001, 68 cases of hepatic carcinoma underwent hepatectomy combined with hepatic artery embolization and chemotherapy for the observation group. Sixty-three patients with HCC underwent resection of irregular hepatic carcinoma Surgery combined with peripheral intravenous infusion of chemotherapy for the control group. Results: The 1-, 2-, and 3-year survival rates of the observation group were 86.8%, 47.1% and 35.3% respectively. The 1-, 2- and 3-year survival rates of the control group were 52.4%, 28.6% and 14.3, respectively %. The survival rates of 51 cases with one, two and three years survival rate of lipiodol deposition were 90 6%, 73 6% and 62 23%, respectively, which were 15 cases worse than those of lipiodol Respectively 46 7%, 267%, 13 3%). The one-year and two-year survival rates of 62 patients without portal vein tumor emboli were 85.5% and 69.4%, respectively. There were 6 patients with portal vein tumor thrombus, the 1- and 2-year survival rates were 33.3% and 0% respectively. Conclusion: Irregular hepatectomy combined with hepatic artery embolization and chemotherapy is an effective method for the treatment of liver cancer. The long-term curative effect is obviously superior to irregular hepatic resection combined with peripheral intravenous infusion chemotherapy. Whether the portal vein tumor thrombus, lipiodol deposition is the main factor affecting the efficacy.