[1]吴志远,丁晓毅,黄 蔚,等.门脉粒子支架联合载药微球栓塞治疗肝癌7例[J].介入放射学杂志,2017,(02):161-165.
　WU Zhiyuan,DING Xiaoyi,HUANG Wei,et al.Portal 125I seed stent implantation combined with drug-loaded microsphere embolization for the treatment of HCC： initial results in 7 patients[J].journal interventional radiology,2017,(02):161-165.
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门脉粒子支架联合载药微球栓塞治疗肝癌7例 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2017年02期
页码:
161-165
栏目:
临床研究
出版日期:
2017-02-25

文章信息/Info

Title:
Portal 125I seed stent implantation combined with drug-loaded microsphere embolization for the treatment of HCC： initial results in 7 patients
作者:
吴志远;  丁晓毅;  黄 蔚;  刘 钦;  王子寅;  刘晶晶;  顾俊玮; 费晓燕;  王忠敏
Author(s):
WU Zhiyuan;  DING Xiaoyi;  HUANG Wei;  LIU Qin;  WANG Ziyin;  LIU Jingjing;  GU Junwei;  FEI Xiaoyan;  WANG Zhongmin
Department of Interventional Radiology， Affiliated Ruijin Hospital，School of Medicine， Shanghai Jiaotong University， Shanghai200025， China
关键词:
【关键词】 肝细胞肝癌;  门静脉支架;  125I放射性粒子;  经肝动脉化学栓塞;  载药微球
文献标志码:
A
摘要:
【摘要】 目的 探讨门静脉放射性粒子支架植入联合载药微球经肝动脉化学栓塞术（DEB-TACE）治疗肝细胞肝癌（HCC）伴门静脉主干癌栓（MPVTT）的可行性和安全性。方法 前瞻性单臂研究，7例确诊患者顺序入组接受治疗，比较门静脉支架植入前后门静脉压力变化，术前和术后1～3 d、4 d和5～7 d肝功能变化的差异，总结并发症发生情况。结果 7例患者均为BCLC-C期，Child-Pugh A~B级。均为巨块型肝癌，左肝1例，右肝6例，门静脉左支癌栓1例，右支癌栓6例，均伴有MPVTT。所有患者均顺利进行放射性粒子支架门静脉内植入联合DEB-TACE治疗。支架植入前后门静脉平均压力分别为15.3和10.2 cmH2O，压力下降明显。血清总胆红素（TB）、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）术后一过性增高，3～4 d后逐渐下降，TB恢复较ALT、AST慢。2例患者伴心肌损害，2～3 d后逐渐恢复。结论 联合应用放射性粒子支架门静脉内植入和DEB-TACE治疗HCC合并MPVTT是安全可行的，远期疗效需进一步研究。

参考文献/References:

［1］ Zhang XB， Wang JH， Yan ZP， et al. Hepatocellular carcinoma invading the main portal vein： treatment with transcatheter arterial chemoembolization and portal vein stenting［J］. Cardiovasc Intervent Radiol， 2009， 32： 52-61.
［2］ 张 磊， 陆骊工， 李 勇， 等． 门静脉支架联合肝动脉化疗栓塞治疗肝癌伴门静脉癌栓的临床研究［J］． 介入放射学杂志， 2011， 20： 968-973．
［3］ 刘清欣， 颜志平， 李 说， 等． 125I粒子条联合门静脉支架及化疗栓塞治疗原发性肝癌合并门静脉癌栓［J］． 介入放射学杂志， 2009， 18： 593-595．
［4］ Luo JJ， Zhang ZH， Liu QX， et al. Endovascular brachytherapy combined with stent placement and TACE for treatment of HCC with main portal vein tumor thrombus［J］. Hepatol Int， 2016， 10： 185-195.
［5］ Poon RT， Tso WK， Pang RW， et al. A phaseⅠ/Ⅱtrial of chemoembolization for hepatocellular carcinoma using a novel intra-arterial drug-eluting bead［J］. Clin Gastroenterol Hepatol， 2007， 5： 1100-1108.
［6］ Villa E， Moles A， Ferretti I， et al. Natural history of inoperable hepatocellular carcinoma： estrogen receptors’ status in the tumor is the strongest prognostic factor for survival［J］. Hepatology， 2000， 32： 233-238.
［7］ Zhang YQ， Fan WZ， Wang Y， et al. Sorafenib with and without transarterial chemoembolization for advanced hepatocellular carcinoma with main portal vein tumor thrombosis： a retrospective analysis［J］. Oncologist， 2015， 20： 1417-1424.
［8］ Lu XJ， Dong J， Ji LJ， et al. Safety and efficacy of TACE and gamma knife on hepatocellular carcinoma with portal vein invasion［J］. Gut， 2016， 65： 715-716.
［9］ Long J， Zheng JS， Sun B， et al. Microwave ablation of hepatocellular carcinoma with portal vein tumor thrombosis after transarterial chemoembolization： a prospective study［J］. Hepatol Int， 2016， 10： 175-184.
［10］ Lammer J， Malagari K， Vogl T， et al. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma： results of the PRECISION Ⅴ study［J］. Cardiovasc Intervent Radiol， 2010， 33： 41-52.
［11］ Brown KT， Do RK， Gonen M， et al. Randomized trial of hepatic artery embolization for hepatocellular carcinoma using doxorubicin-eluting microspheres compared with embolization with microspheres alone［J］. J Clin Oncol， 2016， 34： 2046-2053.

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备注/Memo

备注/Memo:
（收稿日期：２０１6-０6-1０）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2017-02-13