[1]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,(12):968-973.
　ZHANG Lei,LU Li-gong,LI Yong,et al.Portal vein stent placement combined with TACE for the treatment of hepatocellular carcinoma associated with tumor thrombus in portal vein[J].journal interventional radiology,2011,(12):968-973.
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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()

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

卷:
期数:
2011年12期
页码:
968-973
栏目:
肿瘤介入
出版日期:
2011-12-30

文章信息/Info

Title:
Portal vein stent placement combined with TACE for the treatment of hepatocellular carcinoma associated with tumor thrombus in portal vein
作者:
 张　　　磊; 　　　陆骊工; 　　　李　　　勇; 　　　邵培坚; 　　　胡宝山; 　　　魏照光; 　　　何　　　旭; 　　　禹娴怡; 　　　罗小宁
510080 广东省人民医院肿瘤中心介入治疗科，广东省医学科学院
Author(s):
ZHANG Lei;  LU Li-gong;  LI Yong;  SHAO Pei-jian;  HU Bao-shan;  WEI Zhao-guang;  HE Xu;  YU Xian-yi;  LUO Xiao-ning.
Department of Interventional Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
关键词:
 ; 【关键词】 肝癌;  门静脉癌栓;  经皮经肝门静脉内支架植入术;  经导管动脉化疗栓塞
文献标志码:
A
摘要:
 【摘要】 目的 探讨经皮肝门静脉内支架植入术（ＰＴＰＶＳ）联合肝动脉化疗栓塞（ＴＡＣＥ）治疗肝癌伴门静脉癌栓的临床疗效及安全性，并探索影响疗效的因素。方法 ２００９年１月－ ２０１０年１０月在已临床确诊为肝癌伴门静脉癌栓患者中，按要求筛选病例６２例，采用对照、非随机方法分为治疗组和对照组，对照组３０例单接受ＴＡＣＥ治疗；治疗组３２例先接受ＰＴＰＶＳ再行ＴＡＣＥ治疗，其中２例病例放置门静脉支架未成功。评价指标为总生存时间和安全性。随访患者生存时间，并记录ＰＴＰＶＳ术后并发症。用 ＫａｐｌａｎＭｅｉｅｒ 生存分析法分析患者生存时间，两组间生存时间比较用 Ｌｏｇｒａｎｋ法检验；用 Ｃｏｘ 比例风险回归模型探讨影响患者临床预后的因素。结果　　　治疗组中位总生存期为６．５个月，对照组中位总生存期为４．５个月（治疗组风险比为０．５７０，９５％ＣＩ为０．３２８　～　０．９９２，Ｐ ＝ ０．０３７），两组间差异有统计学意义（Ｐ ＜０．０５）。治疗组３０例患者在３、６、１２和１８个月积累生存率分别为７０％、５６．７％、１０％、３．３％。治疗组在术后１周内未出现手术相关并发症，远期出现的并发症有肝性脑病（２例，６．６％）、上消化道出血（呕血或黑便，３例，１０％）、肝肾综合征（１例，３．３％）。结论　　　在肝癌合并门静脉一级分支或（和）门静脉主干不完全闭塞癌栓患者中，ＰＴＰＶＳ联合ＴＡＣＥ治疗组中位生存期比单独ＴＡＣＥ治疗组延长约２个月。治疗方案的安全性较好。 

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(收稿日期:2011-04-28)
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