本文選題：肝腫瘤 + 高血壓　； 參考：《重慶醫(yī)學》2017年35期

【摘要】：目的評價原發(fā)性肝癌合并肝硬化門靜脈高壓者行經(jīng)導管肝動脈化療栓塞(TACE)聯(lián)合經(jīng)頸靜脈肝內門體分流(TIPS)術的安全性及療效。方法收集該院2011年1月至2015年1月因肝癌合并肝硬化門靜脈高壓失代償行TACE聯(lián)合TIPS的患者22例作為聯(lián)合組,篩選僅行TACE治療而未行TIPS治療的肝癌合并肝硬化患者28例作為對照組。觀察兩組患者的治療療效及預后。結果 TIPS治療手術成功率為100%,術前門靜脈壓力為(38.4±7.6)cm H_2O,術后門靜脈壓力為(28.4±7.7)cm H_2O,差異有統(tǒng)計學意義(P0.05);術前門靜脈直徑為(16.2±2.5)mm,術后門靜脈直徑為(13.3±1.8)mm,差異有統(tǒng)計學意義(P0.05)。術后1年支架通暢率為95%,2年通暢率為90%。對照組1年及2年再出血率分別為60.7%及78.5%,而聯(lián)合組為9.1%、13.6%,差異有統(tǒng)計學意義(P0.05)。聯(lián)合組1年累計生存率為81%,2年累計生存率為68%,中位生存時間為53個月;對照組1年累計生存率為78%,2年累計生存率為15%,中位生存時間為17個月,差異有統(tǒng)計學意義(P0.05)。結論肝癌合并門靜脈高壓行TACE聯(lián)合TIPS治療能安全、有效地控制腫瘤發(fā)展,減少甚至消除門靜脈高壓癥候群,提高患者生活質量及生存率。
[Abstract]:Objective to evaluate the safety and efficacy of transcatheter hepatic artery chemoembolization (TACEE) combined with transjugular intrahepatic portosystemic shunt (TIPS) in patients with primary liver cancer complicated with cirrhosis and portal hypertension. Methods from January 2011 to January 2015, 22 patients with liver cancer complicated with portal hypertension decompensated with TACE and TIPS were collected as the combined group. A total of 28 patients with liver cancer complicated with liver cirrhosis were selected as control group who were treated only with TACE but not treated with TIPS. To observe the curative effect and prognosis of the two groups. Results the success rate of TIPS was 100, the preoperative portal vein pressure was 38.4 鹵7.6)cm H2Oand the postoperative portal vein pressure was 28.4 鹵7.7)cm H2O.The difference was statistically significant (P 0.05), and the preoperative portal vein diameter was 16.2 鹵2.5mm, the postoperative portal vein diameter was 13.3 鹵1.8mm. the difference was statistically significant (P0.05). The patency rate of stent 1 year and 2 years was 95 and 90 respectively. The rebleeding rates in the control group were 60.7% and 78.5%, respectively, while those in the combined group were 9.1% and 13.613.60.The difference was statistically significant (P 0.05). The 1-year cumulative survival rate, 2-year cumulative survival rate and median survival time were 81, 68 and 53 months respectively in the combined group, and 78, 15 and 17 months in the control group, respectively. The difference was statistically significant (P 0.05). Conclusion TACE combined with TIPS can effectively control tumor development, reduce or even eliminate portal hypertension syndrome, and improve the quality of life and survival rate of HCC patients with portal hypertension.
【作者單位】： 重慶醫(yī)科大學附屬第二醫(yī)院放射科;
【分類號】：R575.2;R735.7

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