摘要
目的探讨应用载药微球经肝动脉化疗栓塞(drug-eluting beads trancatheter arterial chemoembolization DEB-TACE)治疗经颈静脉肝内门体静脉分流术(TIPS)后原发性肝癌的安全性和有效性。方法选取我院20例TIPS术后原发性肝癌患者行DEB-TACE治疗的临床资料,应用改良实体瘤疗效评价标准(mRECIST)评价栓塞后治疗效果,比较栓塞治疗前后肝功能变化及不良反应。结果20例患者实施DEB-TACE治疗前超声或造影检查TIPS分流道均通畅,共实施DEB-TACE治疗32次,技术成功率为100%。随访6个月,根据mRECIST评估水准,术后1个月、3个月及6个月疾病客观缓解率(ORR)依次为90%、70%和65%,疾病控制率(DCR)依次为95%、80%和80%。术后3天及7天,肝脏功能表现为谷草转氨酶(AST)、谷丙转氨酶(ALT)及总胆红素(TBIL)较术前显著增高,差异有统计学意义(P<0.05),术后两周上述指标接近正常水平,与术前相比差异无统计学意义(P>0.05)。白蛋白及血氨水平无明显变化,术后不良反应主要为发热、腹痛及恶心呕吐,无肝脓肿、肝性脑病及肝衰竭等并发症发生。结论DEB-TACE治疗TIPS术后原发性肝癌近期疗效安全、可靠,远期疗效仍需进一步总结分析。
Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization with drug-loaded microspheres in the treatment of primary liver cancer after transjugular intrahepatic portosystemic shunt(TIPS).Methods The clinical data of 20 patients with primary liver cancer after TIPS were treated with DEB TACE in our hospital were retrospectively analyzed.Modified solid Tumor Efficacy Evaluation Criteria(mRECIST)was used to evaluate the therapeutic effect after embolization,and the changes of liver function and adverse reactions before and after embolization were compared.Results TIPS examined by ultrasound or contrast before DEB TACE treatment was patency in 20 patients,and a total of 32 times of DEB TACE treatment were performed,with the technical success rate of 100%.According to mRECIST evaluation criteria,the objective disease response rates(ORR)at 1,3 and 6 months after DEB-TACE treatment were 90%,70%and 65%,and the disease control rates(DCR)were 95%,80%and 80%,respectively.On day 3 and day 7 after DEB-TACE treatment,the main liver function indexes of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and bilirubin were significantly higher than before,with statistical significance(P<0.05).And gradually recovered to normal 15 days after operation,and there was no statistical difference compared with that before operation(P>0.05).There were no significant changes in albumin and blood ammonia levels.Postoperative adverse reactions were mainly fever,abdominal pain,nausea and vomiting,and no liver abscess,hepatic encephalopathy,and liver failure occurred.Conclusion The short-term efficacy of DEB-TACE in the treatment of primary liver cancer after TIPS is safe and reliable,and the long-term efficacy needs to be studied further.
作者
陈静
曹莉明
崔进国
康志龙
王颖
周炜
CHEN Jing;CAO Liming;CUI Jinguo;KANG Zhilong;WANG Ying;ZHOU Wei(Department of Interventional Therapy,the 980th Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Thoracic surgery,Xinle People's Hospital,Xinle 050000,China;Department of Interventional Radiology,Bao Ding NO.1 Central Hospital,Baoding 050070,China)
出处
《医学影像学杂志》
2024年第10期67-70,共4页
Journal of Medical Imaging
基金
河北省医学科学研究重点课题(编号:20242387)。
关键词
原发性肝癌
经颈内静脉肝内门体分流术
肝动脉化疗栓塞术
载药微球
介入性
放射学
Primary liver cancer
Transjugular intrahepatic portosystemic shunt
Transcatheter arterial chemoembolization
Drug-eluting beads
Interventional radiology
