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单长胜,王松,于春鹏,谭好飞,李舰,李健,李子祥,孙成建.门静脉支架同步¹²⁵I粒子条植入联合经导管动脉化疗栓塞术治疗肝癌伴门静脉癌栓[J].中国医学影像技术,2015,31(3):429~433

门静脉支架同步¹²⁵I粒子条植入联合经导管动脉化疗栓塞术治疗肝癌伴门静脉癌栓

Portal vein stenting combined with linear ¹²⁵I seed strand implantation and TACE for treatment of hepatocellular carcinoma with portal vein tumor thrombus

投稿时间：2014-10-14 修订日期：2015-01-12

DOI：10.13929/j.1003-3289.2015.03.029

中文关键词: 癌,肝细胞门静脉放射性同位素碘化学栓塞,治疗性支架

英文关键词:Carcinoma, hepatocellular Portal vein Iodine radioisotopes Chemoembolization, therapeutic Stents

基金项目:

作者	单位	E-mail
单长胜	青岛大学附属医院介入医学科, 山东青岛 266000
王松	青岛大学附属医院介入医学科, 山东青岛 266000	derekqyfy@126.com
于春鹏	青岛大学附属医院介入医学科, 山东青岛 266000
谭好飞	青岛大学附属医院介入医学科, 山东青岛 266000
李舰	青岛大学附属医院介入医学科, 山东青岛 266000
李健	青岛大学附属医院介入医学科, 山东青岛 266000
李子祥	青岛大学附属医院介入医学科, 山东青岛 266000
孙成建	青岛大学附属医院介入医学科, 山东青岛 266000

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中文摘要:

目的探讨门静脉支架同步¹²⁵I粒子条植入联合TACE治疗肝癌伴门静脉癌栓的临床效果。方法对15例肝癌伴门静脉癌栓患者先行经皮肝穿刺门静脉支架同步¹²⁵I粒子条植入术,再行TACE治疗,随访并计算其累积生存率和支架通畅率。结果对所有患者均成功植入门静脉支架及¹²⁵I粒子条,未出现穿刺道出血、胆汁瘘及急性肝肾衰减等严重并发症。对全部患者共行38次TACE治疗。术后随访6~12个月,3例存活,12例死亡,其中4例死于消化道出血,2例死于肺转移,6例死于肿瘤进展致肝衰减。术后3、6、9、12个月累积生存率和支架通畅率分别为100%、60.0%、46.7%、20.0%和100%、73.3%、40.0%、20.0%。结论采用门静脉支架同步¹²⁵I粒子条植入联合TACE治疗肝癌合并门静脉癌栓安全、可行。

英文摘要:

Objective To assess the clinical efficacy of portal vein stenting combined with linear ¹²⁵I seed strand implantation and TACE for treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods Fifteen patients with HCC accompanied with PVTT underwent portal vein stenting combined with linear ¹²⁵I seed strand implantation and TACE treatment later. The patients were followed-up, and the cumulative survival rate and stent patency rate were calculated. Results Stents and ¹²⁵I seed strands were successfully placed in the portal veins in all patients, no severe complications occured, such as puncture bleeding, bile leak and acute liver and kidney failure. Thirty-eight TACE were operated. During follow-up period of 6—12 months, 3 patients remained alive, and among 12 dead patients, 4 died of gastrointestinal bleeding, 2 died of lung metastasis and 6 died of hepatic dysfunction. The survival rates at 3, 6, 9 and 12 month was 100%, 60.0%, 46.7%, 20.0%, and the stent patency rates was 100%, 73.3%, 40.0%, 20.0%, respectively. Conclusion The portal vein stenting combined with linear ¹²⁵I seed strand implantation and TACE for treatment of HCC with PVTT is safe and feasible.

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