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目的 比较肝动脉灌注化疗及栓塞 (TACE)加经皮注射无水乙醇 (PEI)与单纯TACE治疗有包膜、单个、大病灶原发性肝癌的疗效。资料与方法 45例原发性肝癌患者随机分成A、B两组。A组 (n =2 3)在预先经导管TACE治疗后 ,在B超引导下行PEI治疗。B组 (n =2 2 )单纯TACE治疗。结果 TACE组肿瘤治疗的部分缓解率仅为 9% ,1、2、3年生存率分别为 5 9%、32 %和 0 % ;病灶完全坏死率为 0 % (0 /5 )。相比之下 ,TACE +PEI组肿瘤治疗的部分缓解率增加到 40 % (P <0 .0 5 ) ,1、2、3年生存率分别为 88%、5 6 %和 2 1% (P <0 .0 5 ) ;病灶完全坏死率为 6 7%(4 /6 )。结论 PEI+TACE对有包膜的单个大病灶肝癌的治疗是安全、有效的 ,对这一部分患者进行二期切除手术也是有好处的。
Objective To compare the efficacy of hepatic arterial infusion chemotherapy and embolization (TACE) plus percutaneous injection of absolute alcohol (PEI) and simple TACE in the treatment of primary hepatic carcinoma with enveloped, single and major lesions. Materials and Methods 45 patients with primary liver cancer were randomly divided into A and B groups. Group A (n = 23) underwent pre-catheter TACE treatment and underwent B-guided PEI. Group B (n = 2 2) TACE alone treatment. Results The partial remission rate of TACE group was only 9%. The survival rates at 1, 2 and 3 years were 59%, 32% and 0%, respectively. The complete necrosis rate was 0% (0/5). In contrast, the TACE + PEI group had a partial response rate of 40% (P <0.05) for tumor treatment and 1, 2, 3-year survival rates were 88%, 56%, and 21% <0. 05). The complete necrosis rate was 67% (4/6). Conclusions PEI + TACE is safe and effective for the treatment of single large hepatocellular carcinoma with envelopment. It is also beneficial for this part of patients to undergo second-stage resection.