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目的:探讨n 125I粒子植入治疗原发性肝癌合并门静脉癌栓的价值。n 方法:回顾性分析2015年1月至2018年6月间郑州大学附属肿瘤医院218例原发性肝癌合并门静脉癌栓的患者[男184例，女34例，年龄(53.8±9.2)岁]资料。对患者行CT引导下n 125I粒子植入术，于术后2～3个月复查CT、肝功能，比较治疗前后门静脉癌栓直径、肝功能参数及腹腔积液等并发症情况，并随访2～26个月，计算患者的生存期。应用配对n t检验进行统计比较。n 结果:125I粒子植入后2～3个月，218例患者中癌栓完全缓解8例(3.7%)，部分缓解111例(50.9%)，无变化80例(36.7%)，疾病进展19例(8.7%)，总有效率为91.3%(199/218)。治疗后癌栓直径为(12.63±4.64) mm，较治疗前减小[(26.65±10.88) mm；n t＝18.74，n P<0.01]；血清胆红素、直接胆红素分别为(20.59±10.29)、(11.40±8.37) pg/L，与治疗前[(24.27±12.65)、(15.64±7.99) pg/L]相比差异均有统计学意义(n t值：5.37、8.44，均n P0.05)。142例有腹腔积液的患者中86例治疗后较治疗前积液情况好转。所有患者均未见与治疗相关的严重并发症。至随访结束，162例死亡，56例存活，患者总生存期(9.23±0.59)个月。n 结论:125I粒子植入可安全、有效地治疗原发性肝癌合并门静脉癌栓，并改善腹腔积液。n “,”Objective:To investigate the clinical value of n 125I seeds implantation in the treatment of primary liver cancer with portal vein tumor thrombus.n Methods:A total of 218 patients (184 males and 34 females, age: (53.8±9.2) years) with primary liver cancer with portal vein tumor thrombus between January 2015 and June 2018 were retrospectively analyzed. All patients underwent n 125I seeds implantation under CT guidance. CT examination and liver function test were repeated 2-3 months after the implantation, and the portal vein tumor thrombus diameter, liver function parameters and ascites before and after treatment were compared. All patients were followed up for 2-26 months and the survival time were calculated. Paired n t test was used for data analysis.n Results:Among 218 patients, 8 patients (3.7%) had complete remission of tumor thrombus, 111 patients (50.9%) had partial remission, 80 patients (36.7%) had no change, and 19 patients (8.7%) had disease progression 2-3 months after the implantation. The total effective rate was 91.3%(199/218). The diameter of tumor thrombus after treatment was (12.63±4.64) mm, which was significantly smaller than that before treatment ((26.65±10.88) mm; n t=18.74, n P<0.01); serum bilirubin, the direct bilirubin after treatment were different compared with those before treatment: (20.59±10.29)n vs (24.27±12.65) pg/L (n t=5.37, n P<0.05), (11.40±8.37)n vs (15.64±7.99) pg/L (n t=8.44, n P0.05). Ascites in 86/142 patients were better after the implantation. No serious complications associated with treatment were seen. There were 162 patients died and 56 patients survived till the end of follow-up. The survival time of all patients was (9.23±0.59) months.n Conclusion:125I seeds implantation can safely and effectively treat the portal vein tumor thrombus in patients with primary liver cancer, and improve the clinical symptoms such as ascites.n