林介军 卢立杰 金小军 鲍洛文

    [摘要] 目的 探讨门静脉金属支架同步125I粒子条植入序贯经肝动脉化疗栓塞(TACE)治疗原发性肝癌合并门脉癌栓(PVTT)患者的临床效果。 方法 选择2013年7月～2016年12月温州市中心医院符合纳入标准的原发性肝癌伴门静脉主干癌栓患者21例作为研究对象，行门静脉内金属支架及125I粒子条植入序贯TACE治疗并进行随访。 结果 共植入21枚门静脉支架，植入粒子10～18枚/例。所有患者门静脉支架和125I粒子条均成功植入，手术成功率为100%，未发生手术相关严重并发症。21例患者共接受38次TACE治疗，平均(1.8±0.9)次。术前及术后30 d总胆红素、凝血酶原时间、白蛋白和白细胞计数比较，差异均无统计学意义(P > 0.05)。患者平均生存期为(389.1±79.9)d，中位生存期为358.0 d。术后90、180 d和360 d的累积生存率分别为95.2%、66.7%和47.6%，支架通畅率分别为100.0%、76.2%和57.0%。 结论 门脉内金属支架同步125I粒子条植入联合TACE治疗原发性肝癌合并门静脉主干癌栓的临床效果较好，值得临床进一步推广应用。

    [关键词] 癌，肝细胞；125I粒子；支架；经动脉化疗栓塞术；门脉；癌栓

    [中图分類号] R735.7 [文献标识码] A [文章编号] 1673-7210(2018)06(b)-0085-04

    [Abstract] Objective To evaluate the clinical effect of synchronous iodine-125(125I) seed strand implantation and transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma combined with portal vein main tumor thrombus (PVTT). Methods From July 2013 to December 2016， 21 patients with hepatocellular carcinoma complicated by PVTT in Wenzhou Central Hospital were selected as the research subjects. Intravenous metal stents and 125I seed strips were implanted in sequential TACE therapy and all patients were followed up. Results A total of 21 portal vein stents were implanted and 10-18 particles per person. All patients were successfully implanted portal vein stents and 125I particle strips ......