CAJ | 학술논문

目的观察介入栓塞治疗肝细胞癌伴肝动脉-门静脉分流(APS)的临床疗效，以期提高患者的生存质量和生存期。方法选择诊断明确的29例肝细胞癌伴APS患者，聚乙烯醇(PVA)颗粒、钢圈栓塞后常规行介入化疗栓塞术(TACE)治疗，观察临床症状的改善情况及不良反应的处理及患者的生存率。结果29例患者中19例1次栓塞APS闭塞[成功率65.5％(19/29)]；3例栓塞后APS重新开通[开通率10.3％(3/29)]，经再次栓塞后消失；7例出现新的APS[发生率24.1％(7/29)，其中5例栓塞2次、2例栓塞3次]。术后患者消化道出血、腹泻、腹水的有效率分别为91.7％（11/12）、84.6％( 11/13)、83.3％(15/18)。随访1个月至2年，3个月、6个月、1年和2年生存率分别为96.6％( 28/29)、89.7％(26/29)、65.5％(19/29)和34.5％(10/29)。结论介入治疗伴APS的肝细胞癌患者临床上是安全有效的。
목적관찰개입전새치료간세포암반간동맥-문정맥분류(APS)적림상료효，이기제고환자적생존질량화생존기。방법선택진단명학적29례간세포암반APS환자，취을희순(PVA)과립、강권전새후상규행개입화료전새술(TACE)치료，관찰림상증상적개선정황급불량반응적처리급환자적생존솔。결과29례환자중19례1차전새APS폐새[성공솔65.5％(19/29)]；3례전새후APS중신개통[개통솔10.3％(3/29)]，경재차전새후소실；7례출현신적APS[발생솔24.1％(7/29)，기중5례전새2차、2례전새3차]。술후환자소화도출혈、복사、복수적유효솔분별위91.7％（11/12）、84.6％( 11/13)、83.3％(15/18)。수방1개월지2년，3개월、6개월、1년화2년생존솔분별위96.6％( 28/29)、89.7％(26/29)、65.5％(19/29)화34.5％(10/29)。결론개입치료반APS적간세포암환자림상상시안전유효적。
Objective To observe the clinical effect of interventional embolization on hepatocellular carcinoma (HCC) with hepatic arterioportal shunts (APS) ,in the hope of improving patients' survival quality and time. Methods Twenty-nine patients with HCC patients and APS after a successful PVA,steel coils embolization, all patients were given routine TACE therapy. The changes of gastrointestinal bleeding,ascites,diarrhea and aminotransferase were analyzed retrospectively. Results Nineteen cases got successful embolization in the first time [achievement ratio 65.5％(19/29)]; 3 cases got recurrence after embolization [patency ratio 10.3％(3/29)],7 cases appeared new APS [incidence ratio 24.1％(7/29),5 cases were embolized 2 times, 2 cases were embolized 3 times]. The effective rate of gastrointestinal bleeding,diarrhoea,aacites were 91.7％ (11/12), 84.6％ ( 11/13 ), 83.3％ ( 15/18 ) respectively, which had significant difference between preoperative and postoperative condition. The survival rate of 3 months,6 months, 1 year,and 2 years after operation were 96.6％ (28/29),89.7％ (26/29),65.5％ (19/29),34.5％ (10/29). Conclusion Interventional therapy is a safe and effective treatment to HCC with APS.