肝癌合并肝硬化门静脉高压行TACE联合TIPS治疗的安全性与疗效

发布时间：2018-05-18 01:05

本文选题：肝肿瘤 + 高血压　；参考：《重庆医学》2017年35期

【摘要】：目的评价原发性肝癌合并肝硬化门静脉高压者行经导管肝动脉化疗栓塞(TACE)联合经颈静脉肝内门体分流(TIPS)术的安全性及疗效。方法收集该院2011年1月至2015年1月因肝癌合并肝硬化门静脉高压失代偿行TACE联合TIPS的患者22例作为联合组,筛选仅行TACE治疗而未行TIPS治疗的肝癌合并肝硬化患者28例作为对照组。观察两组患者的治疗疗效及预后。结果 TIPS治疗手术成功率为100%,术前门静脉压力为(38.4±7.6)cm H_2O,术后门静脉压力为(28.4±7.7)cm H_2O,差异有统计学意义(P0.05);术前门静脉直径为(16.2±2.5)mm,术后门静脉直径为(13.3±1.8)mm,差异有统计学意义(P0.05)。术后1年支架通畅率为95%,2年通畅率为90%。对照组1年及2年再出血率分别为60.7%及78.5%,而联合组为9.1%、13.6%,差异有统计学意义(P0.05)。联合组1年累计生存率为81%,2年累计生存率为68%,中位生存时间为53个月;对照组1年累计生存率为78%,2年累计生存率为15%,中位生存时间为17个月,差异有统计学意义(P0.05)。结论肝癌合并门静脉高压行TACE联合TIPS治疗能安全、有效地控制肿瘤发展,减少甚至消除门静脉高压症候群,提高患者生活质量及生存率。
[Abstract]:Objective to evaluate the safety and efficacy of transcatheter hepatic artery chemoembolization (TACEE) combined with transjugular intrahepatic portosystemic shunt (TIPS) in patients with primary liver cancer complicated with cirrhosis and portal hypertension. Methods from January 2011 to January 2015, 22 patients with liver cancer complicated with portal hypertension decompensated with TACE and TIPS were collected as the combined group. A total of 28 patients with liver cancer complicated with liver cirrhosis were selected as control group who were treated only with TACE but not treated with TIPS. To observe the curative effect and prognosis of the two groups. Results the success rate of TIPS was 100, the preoperative portal vein pressure was 38.4 卤7.6)cm H2Oand the postoperative portal vein pressure was 28.4 卤7.7)cm H2O.The difference was statistically significant (P 0.05), and the preoperative portal vein diameter was 16.2 卤2.5mm, the postoperative portal vein diameter was 13.3 卤1.8mm. the difference was statistically significant (P0.05). The patency rate of stent 1 year and 2 years was 95 and 90 respectively. The rebleeding rates in the control group were 60.7% and 78.5%, respectively, while those in the combined group were 9.1% and 13.613.60.The difference was statistically significant (P 0.05). The 1-year cumulative survival rate, 2-year cumulative survival rate and median survival time were 81, 68 and 53 months respectively in the combined group, and 78, 15 and 17 months in the control group, respectively. The difference was statistically significant (P 0.05). Conclusion TACE combined with TIPS can effectively control tumor development, reduce or even eliminate portal hypertension syndrome, and improve the quality of life and survival rate of HCC patients with portal hypertension.
【作者单位】：重庆医科大学附属第二医院放射科;
【分类号】：R575.2;R735.7

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