原发性肝癌合并下腔静脉-右心房癌栓17例介入治疗体会

发布时间：2018-03-22 19:11

本文选题：肝肿瘤　切入点：腔静脉　出处：《介入放射学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的评价TACE治疗原发性肝癌合并下腔静脉(IVC)-右心房(RA)癌栓的安全性和临床疗效。方法 17例原发性肝癌合并IVC-RA癌栓患者,行选择性动脉造影确认肿瘤供血动脉,之后行TACE。栓塞材料包括化疗药物-碘化油混合乳剂及颗粒型栓塞材料,栓塞的靶血管包括肝动脉分支、右侧膈下动脉、胃左动脉分支等。术后定期随访,酌情行进一步治疗。结果 17例患者共行TACE治疗45次,所有治疗均成功,无明显并发症。17例患者IVC-RA癌栓均可见明确供血动脉,肝动脉分支供血12例,肝外动脉供血9例,其中胃左动脉1例,右侧膈下动脉8例。复查CT,15例患者可见IVC-RA癌栓内碘油沉积。17例患者的中位生存期为12个月,1、2年生存率分别为52.9%、29.4%。结论原发性肝癌IVC-RA癌栓血供丰富,主要供血动脉包括肝动脉、右侧膈下动脉,TACE是治疗原发性肝癌合并IVC-RA癌栓的安全有效方法。
[Abstract]:Objective to evaluate the safety and clinical efficacy of TACE in the treatment of primary liver cancer with IVCG-RAA. Methods 17 patients with primary liver cancer complicated with IVC-RA tumor thrombus were identified by selective arteriography. Then TACE.Embolization materials included chemotherapy-lipiodol mixed emulsion and granular embolization materials. The target vessels for embolization included branches of hepatic artery, right inferior phrenic artery, left gastric artery, etc. Results 17 patients were treated with TACE for 45 times. All the treatments were successful. 17 cases with IVC-RA tumor thrombus showed definite feeding artery, 12 cases with hepatic artery branch and 9 cases with extrahepatic artery supply. There were 1 case of left gastric artery and 8 cases of right inferior phrenic artery. The median survival time was 12 months and 1 year, and the 2 year survival rate was 52.9% and 29.429.44% respectively in 17 patients with IVC-RA tumor thrombus. Conclusion there is abundant blood supply in IVC-RA tumor thrombus of primary liver cancer. The right inferior phrenic artery (right inferior phrenic artery) is a safe and effective method for the treatment of primary liver cancer with IVC-RA thrombus.
【作者单位】：海南省人民医院放射介入科;解放军总医院介入放射科;
【分类号】：R735.7

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