论文部分内容阅读
目的探讨肝脾双介入疗法在原发性肝癌伴脾功能亢进(简称脾亢)中的应用价值。方法对35例患者采用SELDINGER方法,将5FRH导管插入肝固有动脉,灌注化疗药物总量的2/3;注入栓塞剂,置换脾管,插入脾动脉,灌注化疗药物总量的1/3;超选至脾动脉下级分支注入凝胶海绵。化疗应用联合方案:5-氟脲嘧啶(5-FU)1000MG、表阿霉素(EADM)60MG、羟基喜树碱(HCPT)30MG或丝裂霉素(MMC)8MG,10例患者加用顺铂(DDP)60MG。栓塞剂为超液化碘油及凝胶海绵。结果30例患者术后4周内白细胞计数为(4.5±2.3)×109/L,血小板计数为(102.1±5.4)×109/L,与术前平均值(2.9×109/LVS41.6×109/L)比较有显著性差异。本组患者6个月生存率为100%,1年生存率为60%。35例中完全缓解(CR)1例,部分缓解(PR)10例,稳定(SD)8例,进展(PD)15例,死亡1例。治疗后的不良反应均为发热,6例肝功能异常。结论肝脾双介入疗法可以缓解脾亢,有效支持原发性肝癌的药物治疗。
Objective To explore the value of dual interventional therapy of liver and spleen in primary hepatocellular carcinoma with hypersplenism (referred to as hypersplenism). Methods SELDINGER method was used in 35 patients. The 5FRH catheter was inserted into the proper hepatic artery, and 2/3 of the total chemotherapeutic drugs were infused. Embolization, splenic tube replacement and splenic artery insertion were performed in 1/3 of the total chemotherapeutic drugs Selected to the lower branches of the splenic artery into the gel sponge. Chemotherapy combination regimen: 5-fluorouracil (5-FU) 1000MG, epirubicin (EADM) 60MG, HCPT 30MG or MMC 8MG, 10 patients with cis Platinum (DDP) 60MG. Embolization agent for ultra liquefied lipiodol and gel sponge. Results The white blood cell count and the platelet count of the 30 patients within 4 weeks after operation were (4.5 ± 2.3) × 109 / L and (102.1 ± 5.4) × 109 / L, respectively, / L) compared with significant differences. The 6-month survival rate of this group of patients was 100%, 1-year survival rate was 60%. Among 35 cases, there were 1 complete remission (CR), 10 partial remission (PR), 8 stable (SD), 15 progressive (PD) and 1 death. Adverse reactions after treatment were fever, 6 cases of liver dysfunction. Conclusion Hepatic spleen double intervention therapy can relieve hypersplenism and effectively support the treatment of primary liver cancer.