125I粒子植入联合TIPS术治疗肝内胆管细胞癌门静脉主干癌栓合并门静脉高压的临床分析

摘要/Abstract

摘要： 目的探讨¹²⁵I粒子植入联合TIPS术治疗肝内胆管细胞癌(ICC)门静脉主干癌栓合并门静脉高压的临床效果。方法研究对象选取2016年1月到2018年12月间贺州市人民医院收治ICC门静脉主干癌栓合并门静脉高压的患者78例。采用随机数字法将其分为对照组和试验组,各39例。对照组采用TIPS术,试验组采用¹²⁵I粒子植入联合TIPS术。比较两组患者治疗前后门静脉压力;比较两组标准缓解率、总有效率;比较两组术后6个月、12个月、24个月的累计生存率、分流道累积再狭窄率、症状复发率。结果治疗后,两组患者门静脉压力均明显低于治疗前,且试验组患者门静脉压力显著低于对照组,差异均具有统计学意义(P<0.05)。试验组标准缓解率、总有效率均显著高于对照组,差异均具有统计学意义(P<0.05)。术后6个月、12个月、24个月,试验组的累计生存率显著高于对照组,差异均具有统计学意义(P<0.05)。术后6个月,试验组的分流道累积再狭窄率、症状复发率均显著低于对照组,差异均具有统计学意义(P<0.05)。结论 ¹²⁵I粒子植入联合TIPS术可明显降低ICC门静脉主干癌栓合并门静脉高压患者的门静脉压力,稳定门静脉主干癌栓,延长患者生存时间。

关键词: ¹²⁵I粒子植入, 经颈静脉门腔静脉分流术, 肝内胆管细胞癌, 门静脉高压

Abstract: Objective To investigate the clinical effect of ¹²⁵I seed implantation combined with transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of intrahepatic cholangiocarcinoma complicated by main portal vein tumor thrombus (MPVTT) and portal hypertension. Methods Seventy-eight patients with intrahepatic cholangiocarcinoma and MPVTT combined with portal hypertension were selected in this study from January 2016 to December 2018. They were divided into a control group and a test group with 39 cases each by random number method. The patients in the control group was treated with TIPS surgery, while the patients in the test group was treated with ¹²⁵I seed implantation in combination with TIPS surgery. The two groups of patients were compared for portal pressure before and after the treatment, the standard remission rate and total effective rate, the cumulative survival rate, cumulative restenosis rate of shunts, and symptom recurrence at 6 months, 12 months, and 24 months after surgery. Results After treatment, the portal pressure of the two groups of patients was significantly lower than those before treatment, and the portal pressure of the test group was significantly lower than that of the control group (P<0.05). The standard remission rate and total effective rate of the experimental group were significantly higher than those of the control group (P<0.05). At 6 months, 12 months, and 24 months after operation, the cumulative survival rate of the test group was significantly higher than that of the control group (P<0.05). At 6 months after operation, the cumulative restenosis rate and symptom recurrence rate of the test group were significantly lower than those of the control group (P<0.05). Conclusion ¹²⁵I seed implantation combined with TIPS may significantly reduce the portal pressure in patients with intrahepatic cholangiocarcinoma and MPVTT and portal hypertension, stabilize tumor thrombus in portal trunk, and prolong the survival time of patients.

Key words: ¹²⁵I seed implantation, Transjugular intrahepatic portosystemic shunt, Intrahepatic cholangiocarcinoma, Portal hypertension

刘念, 刘劲梧. ¹²⁵I粒子植入联合TIPS术治疗肝内胆管细胞癌门静脉主干癌栓合并门静脉高压的临床分析[J]. 肝脏, 2021, 26(10): 1115-1118.

LIU Nian, LIU Jing-wu. Effects of ¹²⁵I seed implantation combined with TIPS in the treatment of intrahepatic cholangiocarcinoma complicated by main portal vein tumor thrombus and portal hypertension[J]. Chinese Hepatolgy, 2021, 26(10): 1115-1118.

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¹²⁵I粒子植入联合TIPS术治疗肝内胆管细胞癌门静脉主干癌栓合并门静脉高压的临床分析

Effects of ¹²⁵I seed implantation combined with TIPS in the treatment of intrahepatic cholangiocarcinoma complicated by main portal vein tumor thrombus and portal hypertension

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