摘要
目的：探讨高强度聚焦超声（HIFU）治疗门静脉癌栓的疗效和安全性。方法：对62例不同程度（Ⅰ～Ⅲ级）的门静脉癌栓患者行HIFU治疗，观察治疗前后的影像学变化、临床症状来评价HIFU的近期有效率（CR+PR）%、临床受益率（CBR）、生存期和不良反应。结果：近期有效率：Ⅰ级88.9%，Ⅱ级33.3%，Ⅲ级5%；临床受益率：Ⅰ级83.3%，Ⅱ级54.2%，Ⅲ级20%；中位生存期：Ⅰ级15.3个月，Ⅱ级10.5个月，Ⅲ级6.1个月；不良反应：Ⅰ～Ⅱ级无不良反应，Ⅲ级有上消化道出血。结论：HIFU是一种有效的治疗门静脉癌栓的方法，具有无创和较高的安全性，应用范围广，也能适合病情较重、肝功能异常、伴有腹水的、不能耐受其他方法治疗的病人。
Abstract
Objective: To explore the safety and curative effect of high intensity focused ultrasound(HIFU) in the treatment of portal vein tumor thrombosis. Methods: Sixty-two patients with primary hepatocellular carcinomas complicated with portal vein tumor thrombosis(Grade Ⅰ～Ⅲ) were treated by HIFU. The treatment effects included imaging changes and clinical symptoms. The rates of local control, clinical benefit response(CBR), average survival period and the frequency of complication were evaluated. Results: The rates of local control were 88.9% in grade Ⅰ, 33.3% in grade Ⅱ, and 5% in grade Ⅲ. The CBR was 83.3% in grade Ⅰ, 54.2% in grade Ⅱ, and 20% in grade Ⅲ. Average survival period for grade Ⅰ, Ⅱ and Ⅲ was 15.3 months, 10.5 months and 6.1 months, respectively. No serious complications were seen in grade Ⅰ and grade Ⅱ. Upper gastrointestinal bleeding were observed in grade Ⅲ. Conclusions: HIFU was non-invasive, safe and effective palliative therapy for the patients with primary hepatocellular carcinomas complicated with portal vein tumor thrombosis. HIFU was effective for the patients who had bad general condition, hepatic dysfunction, ascites, and was intolerable to other treatments.
关键词
肝肿瘤 /
门静脉 /
超声疗法
Key words
Liver neoplasms /
Portal vein /
Ultrasonic therapy
裴 峰;徐周敏;李 娜;黄德美;贺 宁.
高强度聚焦超声治疗门静脉癌栓的临床观察[J]. 中国临床医学影像杂志. 2010, 21(11): 778-782
PEI Feng;XU Zhou-min;LI Na;HUANG De-mei;HE Ning.
Preliminary clinical observation on high intensity focused ultrasound in the treatment of portal vein tumor thrombosis[J]. Journal of China Clinic Medical Imaging. 2010, 21(11): 778-782
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