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目的探讨经动脉灌注治疗原发性肝癌脑转移瘤的效果及并发症。方法 37例肝癌脑转移患者接受颅内动脉灌注化疗,每4周治疗一次,连续3次,两个月复查头部增强核磁共振并进行疗效评价。结果 37例患者均完成3次治疗,手术者动脉插管并灌注治疗成功者37例,术后头痛者13例,均属于轻度不需要处理;中度疼痛11例,给予镇痛处理。发热15例,38.4℃以下13例,未予药物治疗;38.5℃以上2例,给予药物退热。术中、术后未发生严重感染。37例患者完全缓解3例(8.11%),部分缓解21例(56.76%),无变化8例(21.62%),进展5例(13.51%),有效率为64.86%(24/37),患者术后随访24个月,中位生存期8个月,6个月生存期31例(83.78%),9个月生存期4例(10.81%),12个月生存期2例(5.41%),不满1年者18例(48.65%)。结论经动脉灌注治疗肝癌脑转移是具有延长患者生存期,提高患者生活质量,术后全身不良反应轻,微创的治疗方法。
Objective To investigate the effect and complications of transcatheter arterial infusion in the treatment of primary liver cancer with brain metastases. Methods Thirty-seven patients with brain metastases of hepatocellular carcinoma underwent intracranial arterial infusion chemotherapy once every 4 weeks for 3 consecutive months. The head-enhanced MRI was reviewed two months later and the therapeutic effect was evaluated. Results 37 patients completed three treatments. Arterial intubation and infusion of 37 cases of successful surgery, postoperative headache in 13 cases, all belong to the mild do not need to deal with; moderate pain in 11 cases, given analgesic treatment. Fever in 15 cases, 38.4 ℃ following 13 cases, no drug treatment; 38.5 ℃ and above in 2 cases, given drug fever. Intraoperative and postoperative no serious infection. Among the 37 patients, complete remission was achieved in 3 patients (8.11%), partial remission in 21 patients (56.76%), unchanged in 8 patients (21.62%), progression in 5 patients (13.51%), effective rate was 64.86% The patients were followed up for 24 months. The median survival time was 8 months. The 6-month survival rate was 31.7% (83.78%), the 9-month survival rate was 4 cases (10.81%), and the 12-month survival rate was 5.4% , Less than 1 year in 18 cases (48.65%). Conclusion Transarterial infusion for the treatment of hepatocellular carcinoma has the advantages of prolonging survival and improving quality of life of patients with postoperative systemic adverse reactions, minimally invasive treatment.