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| 门静脉金属内支架结合经动脉化疗栓塞手术治疗肝癌门静脉癌栓 |
| 李文涛,董生,贾宁阳,欧阳强,严昺 |
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| (复旦大学肿瘤医院放射诊断科,上海,200032;第二军医大学长征医院影像科,上海,200433) |
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| 摘要: |
| 目的:探讨门静脉金属内支架结合经动脉化疗栓塞术(TACE)治疗肝癌合并门静脉癌栓的临床效果.方法:11例盱癌门静脉癌栓患者采用肝穿刺途径置入门静脉金属内支架,同时(或1周后)行TACE.记录手术成功、狭窄开通、并发症和手术死亡发生情况,随访支架通畅期和患者生存期.结果:门静脉通路穿刺成功率11/11;门脉支架置入成功率10/11;发生肝性脑病及肝功能衰竭1例.支架中位通畅期5.7个月(1～18个月);治疗后3个月、6个月及1年患者生存率分别为5/11、4/11、2/11.结论:对巨块型肝癌合并门静脉癌栓、但无远处广泛转移的患者,采用支架开通门脉主干及远端为非肿瘤所在肝叶的门脉,结合TACE治疗,可取得较好的疗效. |
| 关键词: 肝肿瘤、门静脉癌栓、金属内支架、门静脉、经动脉化疗栓塞术 |
| DOI：10.3724/SP.J.1008.2006.00771 |
| 投稿时间：2005-12-06修订日期：2006-06-01 |
| 基金项目: |
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| Portal vein stenting combined with transcatheter hepatic arterial chemoembolization in treatment of portal vein tumor thrombus in patients with primary hepatic carcinoma |
| LI Wen-tao,DONG Sheng,JIA Ning-yang,OUYANG Qiang,YAN Bing |
| (复旦大学肿瘤医院放射诊断科,上海,200032;第二军医大学长征医院影像科,上海,200433) |
| Abstract: |
| Objeetive：To discuss the clinical outcomes of portal vein stenting combined with transeatheter hepatic arterial ehemoembolization （TACE） in treating portal vein tumor thrombus in the patients with primary hepatic carcinoma （PHC）. Methods： Eleven PHC patients with tumor thrombus in the main branch or trunk of the portal vein were treated with stenting and TACE simultaneously （or TACE were performed 1 week later）. The successful rate of the procedure, the pateney of the obstruction, the complications, the mortality and the survival periods were all recorded. Results： Portal vein puncture was sueeessfully performed in all 11 eases and successful stenting was achieved in 10 eases. Hepatic eneephalopathy combined with hepatic failure was noticed in 1 patient. The median pateney period after stenting was 5.7 （1-18） months. The survival rates of patients at 3, 6 and 12 months after treatment were 5/ 11,4/ 11 and 2/ 11, respectively. Conelusion： Metallic stent implantation combined with TACE has satisfactory outcome in treating tumor thrombus in the main branch and trunk of the portal vein in PHC patients without distant metastases. |
| Key words: liver neoplasms portal cancerous thrombus metallic stent portal vein transeatheter hepatic arterial ehemoembdization |
