CAJ | 학술논문

目的评价术前应用超常规剂量碘油超选择TAE与常规TAE治疗原发性肝癌的价值。方法 1987年8月～1999年12 月12年间27例原发性肝癌分为两组：治疗组17例，应用常规导管或球囊导管超选择至肿瘤供血动脉，阻断其血流，使注射碘油时不产生逆流，将全部动脉肿瘤血管、病变周围正常的小动脉及肝实质和门静脉分支栓塞，栓后25天～121天手术切除；对照组10例，应用一般导管，常规剂量的碘油超选或不超选栓塞肿瘤供血动脉，栓后20天～140天手术切除。对两组病人切除的标本均进行了详细的病理学研究，同时对全部病人随访3～8年。结果治疗组17例中11例肿瘤100%坏死，其余6例坏死率为85%～95%，3、5 年生存率分别为88.2%(15/17)、45.5%(5/11)，3例现生存6～8年；对照组10例中2例肿瘤完全坏死，另8例坏死率为75%～95%，3、5年生存率分别为60.0%(6/10)、14.3%(1/7)。结论术前应用超常规剂量碘油超选择TAE治疗原发性肝癌效果明显好于常规TAE。
목적평개술전응용초상규제량전유초선택TAE여상규TAE치료원발성간암적개치。방법 1987년8월～1999년12 월12년간27례원발성간암분위량조：치료조17례，응용상규도관혹구낭도관초선택지종류공혈동맥，조단기혈류，사주사전유시불산생역류，장전부동맥종류혈관、병변주위정상적소동맥급간실질화문정맥분지전새，전후25천～121천수술절제；대조조10례，응용일반도관，상규제량적전유초선혹불초선전새종류공혈동맥，전후20천～140천수술절제。대량조병인절제적표본균진행료상세적병이학연구，동시대전부병인수방3～8년。결과치료조17례중11례종류100%배사，기여6례배사솔위85%～95%，3、5 년생존솔분별위88.2%(15/17)、45.5%(5/11)，3례현생존6～8년；대조조10례중2례종류완전배사，령8례배사솔위75%～95%，3、5년생존솔분별위60.0%(6/10)、14.3%(1/7)。결론술전응용초상규제량전유초선택TAE치료원발성간암효과명현호우상규TAE。
Objective　To evaluate the value of superselective transcatheter arterial embolization(TAE) with ultra-routine dose iodized oil versus routine TAE before liver resection in primary hepatic carcinoma.M ethods　27 cases of hepatocel lular (HCC) resected after transcatheter arterial embolization from 1987 to 1999 were retrospectively analyzed. According to different therapeutic methods,the patients were divided into two gr oups:therapeutic group(17case),who received superselective TAE with ultra-routi ne dose iodized oil;control group(10cases),who were treated with routine TAE.The c urative effects of the two groups were evaluated by their survival rates and deg rees of tumor necrosis.The surgical specimens were studied histopathologically .Results　The embolization of the supplying artery of the tumor, small normal artery and hepatic parenchyma around tumor was carried in all the 1 7 patients of the therapeutic group,of whom 15 received the embolization of hepa t ic portal vein branches.The interval between the first embolization and operatio n was 25～121 days.The 3-,5-year survival rate was 88.2%,45.5% respectively. Pathological study revealed no viable tumor cells in ll casese and extensive nec r osis (85%～95%)in the remaining 6.As for patients in the control group,only the embolization of the supplying artery of the tumor was carried out and The 3-,5 -,year survival rates were 60.0%、14.3%.Pathological study revealed no viable t umor cells in 2 cases and extensive necrosis (75%～95%)in the remaining 8.Variou s degrees of necrosis were found in the satellite lesions,tumor thrombus in the portal vein and the infiltrating tumor cells in the capsule in all the 27 patien ts.Conclusions　Superselective TAE with ultra-routine dose iodi zed oil before hepatectomy shows more significant clinical effect than routine T AE before hepatectomy for the treatment of primary hepatic carcinoma.