复方苦参配合肝动脉栓塞治疗不能手术切除的原发性肝癌的临床应用研究.docVIP

复方苦参配合肝动脉栓塞治疗不能手术切除的原发性肝癌的临床研究 王红民 程先鸣 （汉口医院 肿瘤科 武汉市430012） [摘要] 目的 肝动脉栓塞化疗（TACE）是目前不能手术切除的原发性肝癌的常规治疗方法，但单纯TACE疗效较差，3年生存率约20%左右。本研究旨在探讨TACE结合复方苦参治疗不能手术切除的原发性肝癌的疗效。 方法 1992年6月至2002年10月间，27例不能手术的原发性肝癌患者接受TACE+复方苦参注射液治疗，同时选用30例同期单纯TACE治疗的患者作为对照组，两组的资料具有可比性。TACE采用Seldingers法经股动脉穿刺插管，插入肝固有动脉后，注入造影剂，明确已插入肿瘤区供血血管后，再注入化疗药物（顺铂：40mg；5-氟尿嘧啶750—1000mg；阿霉素50—60 mg）和超液化碘油配制成10—30ml悬液，同时根据肝癌供血情况用明胶海绵栓塞供血动脉血管，每4周重复。TACE+复方苦参注射液组，在TACE治疗后，复方苦参注射液20ml静滴，连用10天。 结果 TACE+复方苦参注射液组1、2、3年生存期分别为66.67%、48.15%、37.04% ；TACE组1、2、3年生存期分别为53.33%、36.67%、20%。两组相比有显著性差异（p0.05）。结论 TACE+复方苦参注射液治疗可以提高部分不能手术的原发性肝癌的疗效。 关键词 复方苦参注射液；原发性肝癌；肝动脉栓塞；生存期。 Composite Kushen Injection and Combined Transcatheter Arterial Chemoembolization for Unresectable Primary Liver Cancer Wang Hong-min (Hankou Hospital , Wuhan 430012 , China) [Abstract] Objective Transcatheter arterial Chemoembolization (TACE) is the routine treatment for unresectable primary liver cancer , but 3-year survival rate of patients received TACE alone is only about 20% . this research was to evaluate efficacy of composite Kushen Injection Combined with TACE on unresectable primary liver cancer . Methods From Jue 1992 to Oct 2002 , 57 patients with unresectable primary liver cancer were non-randomized to receive TACE plus composite Kushen Injection (27 patients) , or TACE alone (30 patients) as control , For TACE after skiagran confirmed catheterization , supension of 40mg of cisplstin , 50-60mg of epirubicin , 750-1000mg of 5-fuorouracil , and 10-30ml of iodized oil was perfused into hepatic arteries , 1-2mm of Gelfoam partides was given to embolize hepatic arteries according to blood supply conditions of tumors , this process was repeated every 4 weeks . In TACE+ composite Kushen Injection group , composite Kushen Injection : 20ml iv drop , d10 after TACE . Results 1- 2- 3-year survival rates of TACE+ composite Kushen Injection group were sipnificantly highter than those of TACE group (66.67% vs 53.33% ; 48.15% vs 36.67% an