CAJ | 학술논문

目的探讨应用超常规剂量碘油超选择TAE与常规TAE治疗原发性肝癌的疗效，并对其进行比较研究。方法 198 7年8月～1999年12月12年间276例原发性肝癌被分为两组：治疗组167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、病变周围正常的细小动脉及肝实质和门静脉分支栓塞；对照组109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。结果治疗组中，栓塞全部动脉肿瘤血管、病变周围正常的细小动脉及肝实质167例，门静脉分支栓塞109例。1 、2、3、4、5年生存率分别为98.8%(165/167)、79.9%(107/134)、48%(47/98)、36.6(26/71)、25.5%(12/47)；对照组中，仅栓塞了部分或全部动脉肿瘤血管，1、2、3、4、5年生存率分别为79.9%(87/109)、45.5%(40/88)、21.3%、(1 3/61)、10.2%(5/49)、3.1%(1/32)。两组病人1、2、3、4、5年生存率经统计学处理有极显著差异(P<0.01-0.001)，两组病人均无严重合并症发生。结论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。
목적탐토응용초상규제량전유초선택TAE여상규TAE치료원발성간암적료효，병대기진행비교연구。방법 198 7년8월～1999년12월12년간276례원발성간암피분위량조：치료조167례，응용상규도관혹구낭도관초선택지종류공혈동맥，조단기혈류，사주사전유시불산생역류，장전부동맥종류혈관、병변주위정상적세소동맥급간실질화문정맥분지전새；대조조109례，응용일반도관，상규제량적전유초선혹불초선전새종류공혈동맥。결과치료조중，전새전부동맥종류혈관、병변주위정상적세소동맥급간실질167례，문정맥분지전새109례。1 、2、3、4、5년생존솔분별위98.8%(165/167)、79.9%(107/134)、48%(47/98)、36.6(26/71)、25.5%(12/47)；대조조중，부전새료부분혹전부동맥종류혈관，1、2、3、4、5년생존솔분별위79.9%(87/109)、45.5%(40/88)、21.3%、(1 3/61)、10.2%(5/49)、3.1%(1/32)。량조병인1、2、3、4、5년생존솔경통계학처리유겁현저차이(P<0.01-0.001)，량조병인균무엄중합병증발생。결론응용초상규제량전유초선택TAE치료원발성간암효과명현호우상규TAE。
Objective　To evaluate the efficency of superselec tive trasarterial embolization (TAE)with ultra-routine dose inodized oil and TA E in the treatment of primary hepatic carcinoma.Methods　We retr ospectively and statistically analysed 276 cases of primary hepatic carcinoma tr eated with TAE from 1987 to 1999.According to different therapeutic methods,the patients were divided into two groups:therapeutic group (167 cases),who received superselective TAE with ultra-routine dose of iodized oil;109 cases in control g roup were treated with routine TAE.The curative effects of the two groups were e valuated by their survival rates.Results　The embolization of th e supplying artery of the tumor,small normal artery and hepatic parenchyma aroun d tumor was carried on all the 167 patients of the threapeutic group,of whom 109 received the emblization of hepatic portal vein branches.The 1-,2-,3-,4-,5 -year survival rates were 98.8%,79.9%,48%,36.6%,25.5% respectively.As for patie nts in the control group,only the embolization of the supplying artery of the tu mor was carried out and The 1-,2-,3-,4-,5-year survival rates were 79.8%(87 /109)、45.5%(40/88)、21.3%(13/61)、10.2%(5/49)、3.1%(1/32).No severe damage to t he liver and no remarkable complications were found in all the 276 patients.The 1-,2-,3-,4-and 5-year survival rates of patients in both groups were statis tically significant (P<0.01-0.001). Conclusions　Superselective TAE with ultra-routine dose iodi zed oil shows more significant clinical effect than routine TAE does in the treatm ent of primary hepatic carcinoma.