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目的探讨PTCD联合氩氦刀治疗不能切除的原发性肝癌的临床效果。方法对我院2003年2月～2004年12月收治的15例梗阻型肝癌先作PTCD解除黄疸,保护肝、肾功能。然后,用氩氦刀靶向消融治疗肿瘤。术后定期随访观察肝、肾功能及肿瘤大小的变化。结果本组无手术死亡病例。术后生存期大于1年者5例,8个月6例,半年3例。术后2个月死于肝、肾功能衰竭1例。术后肿瘤直径缩小1～4.2cm,平均为2.8cm。总胆红素和直接胆红素降至正常12例,胆管扩张消失10例。未发生与治疗相关的严重并发症。结论氩氦靶向消融联合PTCD,标本兼治,效果肯定,术后并发症少,是提高梗阻型肝癌治疗效果的有效手段。
Objective To investigate the clinical effect of PTCD combined with cryoablation in the treatment of unresectable primary liver cancer. Methods 15 cases of obstructive liver cancer admitted to our hospital from February 2003 to December 2004 were treated with PTCD to relieve jaundice and protect liver and kidney. Then, the tumor was treated with Targeted ablation with an argon-helium cryoablation. Regular follow-up after surgery to observe the liver and kidney function and tumor size changes. Results This group no surgical deaths. Postoperative survival was more than 1 year in 5 cases, 8 months in 6 cases, 6 months in 3 cases. 2 months after the death of liver and kidney failure in 1 case. Tumor diameter decreased 1 ~ 4.2cm, with an average of 2.8cm. Total bilirubin and direct bilirubin decreased to normal in 12 cases, disappearance of bile duct in 10 cases. No serious complications related to treatment occurred. Conclusions Argon-helium targeted ablation combined with PTCD is effective in improving the curative effect of obstructive hepatocellular carcinoma (HCC).