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目的探讨经动脉超选择性肝段或亚肝段联合栓塞治疗小肝癌的临床价值。资料与方法25例小肝癌经肝段或亚肝段超选择性插管,应用超液态碘化油、无水乙醇和高温高压消毒后的明胶海绵颗粒对载瘤肝段或亚肝段进行联合栓塞,术后1~3个月复查AFP、CT和彩色多普勒,随访6个月~5年。结果AFP值于2周内逐渐恢复正常;病灶体积于术后1~3个月明显缩小;12例出现复发或肝内转移,复发或转移时间最短3个月,最长12个月,平均7.5个月,均采取反复栓塞治疗;本组病例平均治疗次数为6次;术后1、3、5年患者生存率分别为88%、72%、52%。结论对于没有外科手术指征或不愿意接受切除手术的小肝癌患者,经动脉超选择性肝段或亚肝段联合栓塞术是一种疗效显著的非手术微创治疗手段,并可取代小肝癌的常规TACE治疗。
Objective To investigate the clinical value of transarterial ultra-selective or sub-hepatic artery embolization in the treatment of small hepatocellular carcinoma. Materials and Methods 25 cases of small hepatocellular carcinoma were trans-selective hepatic or sub-hepatic segments intubated with ultra-liquid iodized oil, anhydrous ethanol and gelatin sponge particles after autoclaving. Embolism, 1 to 3 months after the review of AFP, CT and color Doppler, followed up for 6 months to 5 years. Results The AFP value gradually returned to normal within 2 weeks. The volume of lesion was significantly reduced at 1 to 3 months after operation. Recurrence or intrahepatic metastasis was observed in 12 cases. The shortest recurrence or metastasis was 3 months and the longest was 12 months, with an average of 7.5 Months, were taken repeatedly embolization treatment; The average number of cases in this group of 6 times; 1, 3, 5-year survival rates were 88%, 72%, 52%. Conclusion For patients with small hepatocellular carcinoma who are not indicated by surgical indications or who are not willing to undergo resection, transarterial ultraselective hepatic segmental or sub-hepatic segmental embolization is a non-operative and minimally invasive treatment and can replace small hepatocellular carcinoma Conventional TACE treatment.