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目的探讨CT引导下经皮多种化学消融术联合注射治疗肺肝部实体恶性肿瘤的临床应用价值。方法对36例肺、肝癌患者CT引导下穿刺行50%浓度乙酸,无水乙醇及抗癌药联合注射,尽量一次治疗完全弥散填充病灶消融治疗。分析其疗效。结果 29例一次治疗病灶基本完全药液弥散填充,7例5d后再次治疗完全弥散填充。1月后复查CT均可见病灶有不同程度缩小和/或坏死。半年后27例(27/31)复查病灶缩小及坏死明显,4例(4/31)病灶有增大但其内仍有部分坏死及碘油充填区,5例死于脏器功能衰竭及其它合并症,2例出现远处转移。未见出现治疗加重肝、肺、肾功能衰竭情况及重大并发症发生。结论应用CT引导下经皮多种化学消融术联合注射治疗肺肝部实体恶性肿瘤可使每次治疗病灶最大程度整个范围内药物弥散填充,保证较好的作用效果,而全身作用小,适应面扩宽,减少了治疗次数及相应创伤,增加了患者治疗耐受性,可重复治疗,并可对一些骨转移灶同时行消融及止痛治疗。具有重要的临床应用价值。
Objective To investigate the clinical value of CT-guided percutaneous multiple chemical ablation combined with injection in the treatment of malignant tumors of solid liver and lung. Methods Thirty-six patients with lung and liver cancer underwent CT-guided percutaneous puncture with 50% acetic acid, absolute ethanol and anticancer drugs. The patients were treated by complete ablation and focal ablation. Analysis of its efficacy. Results 29 cases of primary lesions were completely filled with drug solution, 7 cases treated again 5d completely diffuse filled. After review of CT in January are visible lesions have reduced to varying degrees and / or necrosis. After six months, 27 cases (27/31) were found to have lessened and necrotic lesions, 4 cases (4/31) had enlarged lesions but still had some necrosis and lipiodol filling area, 5 cases died of organ failure and others Complications, 2 cases of distant metastasis. No treatment appeared to aggravate liver, lung, kidney failure and major complications. Conclusion CT-guided percutaneous multiple chemical ablation combined with injection of solid tumor of liver and liver can make the maximum extent of each treatment lesion within the entire range of drug diffusion and filling, to ensure better effect, and systemic effect is small, to adapt to face expansion Wide, reducing the number of treatment and the corresponding trauma, increased patient tolerance to treatment, repeatable treatment, and some of the same bone metastases ablation and analgesic treatment. Has important clinical value.