原发性肝癌合并门静脉癌栓的治疗进展_宁海波精选.pdfVIP

海南医学2015年1月第26卷第1期 doi:10.3969/j.issn.1003-6350.2015.01.0023 ·综 述· 原发性肝癌合并门静脉癌栓的治疗进展 宁海波 综述，张其顺 审校 （柳州市工人医院普通外科二病区，广西 柳州 545005） 【摘要】 近年来，随着以肝功能损害程度、肿瘤直径大小和其他相关因素为背景的肝癌各种治疗方法出现，治 疗也逐渐转向以证据为基础的模式。由于门静脉癌栓可导致肿瘤细胞在肝内播散和转移，并加重肝硬化患者门脉 高压，从而引起上消化道大出血，甚至导致肝功能衰竭，故门静脉癌栓是肝癌治疗的难点之一，关系到患者的预后。 目前临床对于肝癌合并门静脉癌栓的治疗方法较多，然而单一治疗方法效果较差，中位生存期较低，合理的治疗原 则一直尚未建立。本文通过综述肝癌合并门静脉癌栓的最新治疗进展，以便为临床治疗提供有效参考。 【关键词】 原发性肝癌；门静脉癌栓；治疗 【中图分类号】 R735.7 【文献标识码】A 【文章编号】 1003—6350（2015 ）01—0074—06 Progressintreatmentforprimaryhepatocellularcarcinomawithportalveintumorthrombus. NINGHai-bo, ZHANGQi-shun.TheSecondDepartmentofGeneralSurgery,LiuzhouWorkerHospital,Liuzhou545005,Guangxi,CHINA 【Abstract】 In recent years, with lesion of liver function, tumor diameter size and other related factors for hepa- tocarcinoma had appeared various treatment methods, the treatment mode is gradually turning to evidence-based mode. Portal vein tumor thrombus could further induce intrahepatic tumor cells dissemination and metastasis and thus aggravate the portal hypertension with liver cirrhosis leading to massive bleeding of upper alimentary tract or failure of liver function. Thus it is now considered as one of the puzzling critical points in the treatment of hepatocarcinoma closely related to the patients prognoses. At the present, the treatments for primary hepatocellular carcinoma with por- tal vein tumor thrombus are varied, but the effect of single treatment is not satisfied and the median survival time is shorter. No reasonableness of the therapeutic principle has been set up. This article comprehensively collected the up- dated progress of treatment for primary hepatocellular carcinoma with portal vein tumor thrombus nowadays to pro-