原发性肝癌合并门静脉癌栓的介入治疗进展_医学论文-毕业论文_304

?iZD8GJMFD0?iZD8/5Tmhb?iZ_ D- 87 182 iPVTT s3 FsYB(TAI) aF(Lp? TACE) aF#Z(LpGs? TACE)3 ZEbPVTT hqsY7.7 a21.4 a37.7 Pf12 433 ?m1 j2 =ssTACE h1 M=?qsY20.00% 39.13% P0.05) b1 j2 =TACE h1 M=?qVT?m ?1 M?qbTACEbBTACE zrbYamada 13 PVTT uab9460Gy TACE 19 HCC iPVTT Z4rq57.9% 1 a2 M3iqsY40.6% 10.2% 3i7.0 PVTT (lbTazawa 14 24 HCC iPVTT b9450Gy TACE 4 CR 8 PR 8 M4 ZbCox sAU?Child s)3iq11 a2 M3iq?Child A )sY73% 21% ?Child B aC )sY10% 0 byN4?aHCC 43iqb3 aoHCC 90% ?8HgTACE ?%i? PVTT gbyN?#PVTT oVETr? PPVTT F0iPVTT V?9TbaoZEv8m7a5/,bTACE $W9#2/,O4b B/,O#?iZD8GJMFD0?iZD8lq68.4 1 a3 M3iqsY73.7 a18.4 bl17 14 ?m6 iPVTT 2 %vTACE 1 2/,O00s30mg 5?Fu 5g bv(Al3 l40% hq16.7%(1/6) lq50%(3/6) M33%(2/6) nhhba18 |45 HCC iPVTT sFF20 TACE 25 BTACE TvFTAUF-AFP MF730190g/L a515395g/L vF752183g/La710213g/L F1sA(PqsY65%(13/20) a32%(8/25)(PY1 a2 a3 M3iqsY92.5% a57.5% 20% b22 |HCC iPVTT 34 B,OPEI PVTT 19 (A F)aPEI PVTT 15 (B F)bTAUB FhaT?Zq#9rqsY 53.3% a33.3% 86.6% A F(sY 36.8%a36.8% 73.6%) 1sA(P0.05) b34 PVTT AFP 628 289.2%(25/28)AFP /B FAFPr 75.0%(9/12) AA F 37.5%(6/16)(P2 bmq94.7% .N7Yq77.8% 2 ?37ha?bOY4 3 a6 a1 M3iqsY43.8%(7/16) a25%(4/16) a12.5%(2/16) bvi)WMOd?=ZEV|zrb!b6 2h2hultrasonic disruption 2oT%?A%3rM%Yi%?MDNA a8Ma%27 28 b29 82hWalker? 256 %4?C%a%yba4U%XsbT%N_?C249v%S /G2+M 9F4U%b9Fb30 ytsPVTT 2hhbTh-Y0 100 23.2cmH2O 14.3cmH2O tiHW1.8 h 8.0 h bH8L?C2hVrvs%b2h?rhH9?r%Tb2h%M%0rXrTb7 l iPVTT 54B-R|8b5VC$#H7YVObbd$PVTT Vmb4mV45aPEI aab38|4iPVTT rB43b?iZD8GJMFD0?iZD8, I, By, . ZErJ. S,1999,7(1):17-20.8 , , q, . (TACE) sr4J. S,2004, 10(6):386-388. 9 Terayama NMiyayama S Tatsu H et al. Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobeJ. J Vasc Intervent Radiol, 1998,9(3):501-508.10 Katsumori T, Fujita M, Satoh O, et al. Effective segmental chemoembolization of advanced hepatocellular carcinoma with tumor thrombus in the portal veinJ. Cardiovasc Intervent Radiol,1995,18(4):217-212.11 Fukuda S, Okuda K, Imamura M, et al. Surgical resection combined with chemotherapy for advanced hepatocellular carcinoma with tumor thrombus: report of 19 casesJ. Surgery, 2002, 131(3):300-310. 12 f, , , . ?TACE il( 433 h) J. S,2005,11(2): 81-82.13 Yamada K, Izaki K, Sugimoto K, et al. Prospective trial of combined transcatheter arterial chemoembolization and three?dimensional conformal radiotherapy for portal vein tumor thrombus in patients with unresectable hepatocellular carcinomaJ.Int J Radiat Oncol Biol Phys, 2003 ,57(1):113-119.14 Tazawa J, Maeda M, Sakai Y, et al. Radiation therapy in combination with transcatheter arterial chemoembolization for hepatocellular carcinoma with extensive portal vein involvementJ. J Gastroenterol Hepatol, 2001,16(6):660-665.15 yS, , E, . ?i“ ” J. 5b, 2003, 22(8):693-697.16 , z, , . 4?iJ. S,1999,7(1):13-14.17 l, , , . 2/,O0J. S2,2005,6(2):97-99.18 a, +, , . ,O?J. S,2005,15(4): 381-382.19 KA, , f, . %ZE1J. ?,2000, 22(3):247-249.20 De Sanctis JT, Goldberg SN, Mueller PR. Percutaneous treatment of hepatic neoplasms: A review of current techniquesJ. Cardiovasc Intervent Radiol, 1998, 21 (4):273-296.21 Yantamoto K, Masuzawa H, Kato M, et al. Evaluation of combined therapy with chemoembolization and ethanol injection for advanced hepatocellular carcinomaJ. Semin Oncol, 1997, 24suppl 6:50-55.22 , , r, . 2J. 2,2004,13(3):195-198.23 Tsukamoto T, Hirohashi K, Kubo S, et al. Percutaneous transhepatic metallic stent placement for malignant portal vein stenosisJ. Hepatogastroenterology, 2003,50(50):453-455. 24 Higaki I, Hirohashi K, Kubo S, et al. Portal vein stenting to treat portal vein tumor thrombus in hepatocellular carcinomaJ. Osaka City Med J, 2000,46(2):99-104. 25 Yamakado K, Tanaka N, Nakatsuka A, et al. Clinical efficacy of portal vein stent placement in patients with hepatocellular carcinoma invading the main portal veinJ. J Hepatol, 1999, 30(4):660-668.?iZD8GJMFD0?iZD8)UNM26 , l, B, . =OJ. 5b,2003,22(6): 498-500.27 Sacks PG, Miller MW, Sutherland RM. Response of multicell spheroids to 1?MHz ultrasonic irradiation: cavitation?related damageJ. Radiation Res, 1983, 93 (3):545-559. 28 Liebeskind D, Bases R, Koenigsberg M, et al. Morphological changes in the surface characteristi