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原发性肝癌268例综合治疗分析 |
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郑树森 梁廷波 吴健
【摘 要】 目的 为了进一步探讨和总结肝癌综合治疗的方法和疗效。方法 回顾性分析了近5年来收治的原发性肝癌268例的治疗方法和初步疗效。其中包括 男229例, 女39例, 平均年龄41岁, 肿瘤多属中晚期。手术137例, 非手术131例, 手术中包 括规则与不规则切除、 一期切除、 二步切除和复发再切除及人体原位肝移植。非手术治疗 包括TACE、 PEI、 DDS、 冷冻、 中医中药、 生物治疗、 全身化疗等方法。结果 手术率为51%(137/268), 全组手术切除率为85%(116/137), 手术死亡率2.2%(3/137), 术后并发症发生率20.9%, 6个月内复发和转移率为20.7%(32/115)。1例大肝癌肝移植后 已存活2 个月, AFP降为正常, 无复发。结论 以手术为主的综合治疗仍是目前原发性肝 癌的理想治疗模式, 积极的治疗值得提倡, 全身化疗不容忽视, 原位肝移植应进一步探讨。
【关键词】 肝癌 手术 TACE 冷冻 DDS PEI 肝移植
The comprehensive treatment for hepatocellular carcinoma(a report of 268 cases).
Zheng Shusen, Liang Tingbo,Wu Jian.
(Department of Hepatobiliary-pancreas Surgery, First Affiliated Hospital, Medical Faculty of Zhejiang University , Hangzhou 310003)
【Abstract】 Objective To explore and sum up the comprehensive treatment modalities and outcome of hepatocellular carcinoma.Methods 268 pat i ents with primary hepatocellular carcinoma were analyzed retrospectively from Ja n 1994 to Jun 1999.The patients consisted of male 229, female 39, average age 4 1 years, operation 137, nonoperation 131.Most of them were TNM Ⅱ～Ⅲ stage.First and sequential re sect ion, recurrent lesions resection again, liver transplant, TACE, PEI, DDS, Cryosu rgery, system chemotherapy, Chinese medicine, et al. were contents of comprehens i ve treatment modalities.Results The operation ratio, resection ratio, recurrent ratio within 6 months, morbidity and motality were 51%(137/ 268 ), 85%(116/137),20.7%(32/115),20.9% and 2.2%(3/137) respectively.One p atien t who received liver transplantation has been surviving for more than two mo nths, AFP level decreased to normal postoperatively.Conclusions Live r resection combined with other nonoperation modalities are ideal ways to treat he pa tocellular carcinoma at the present.System chemotherapy must not be igno red. It is necessary to study further for liver transplantation to HCC.
【Key words】 Liver carcinoma Surgery TACE Cryosurge[1] [2] [3] 下一页
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