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目的 探讨肝癌切除术中肝动脉留置化疗泵对复发的监测、预防和治疗价值。方法 3 4例行肝癌根治性切除者 ,术中肝动脉留置化疗泵 ,定期经化疗泵肝动脉灌注化疗和CO2 超声造影。结果 1)直径≤ 3cm 2 4个肝癌复发灶 ,CO2 超声造影检出率 95 .8% ,而常规超声为 5 0 % (P <0 .0 1)。 2 ) 2 0例单纯肝切除和 3 4例肝切除加肝动脉化疗者 ,其1、3年的复发率分别是 40 %、75 %和 2 9.4%、64 .7% (P <0 .0 5 ) ,1、3年的生存率分别是 70 %、3 0 %和 91.2 %、47.1% (P<0 .0 5 )。结论 肝癌术中肝动脉留置化疗泵 ,术后行肝动脉CO2 超声造影和化疗对于复发的监测、预防和治疗具有重要价值。
Objective To investigate the value of monitoring, prevention and treatment of recurrent hepatic artery chemotherapy pump during hepatectomy. Method 3 4 cases of radical resection of liver cancer, intraoperative hepatic artery indwelling chemotherapy pump, regular chemotherapy by hepatic artery infusion chemotherapy and CO2 contrast echocardiography. Results 1) The recurrence of 4 liver cancers with diameter ≤ 3cm 2, the detection rate of CO2 contrast echocardiography was 95.8%, while the conventional ultrasound was 50% (P <0.01). 2) Twenty cases of simple hepatectomy and 34 cases of hepatectomy and hepatic artery chemotherapies had recurrence rates of 40%, 75% and 294%, 64.7% (P <0. 0) 5). The 1-year and 3-year survival rates were 70%, 30% and 91.2%, respectively, and 47.1% (P <0.05). Conclusions Intrahepatic arterial chemoembolization during hepatic carcinoma surgery is of great value in the monitoring, prevention and treatment of relapse after transcatheter arterial CO2 contrast-enhanced ultrasound and chemotherapy.