超声引导下经皮肝穿刺注射华蟾素与无水乙醇治疗门静脉癌栓的效果比较

冀建峰; 肖秋金; 邓晓莉

doi:10.3969/j.issn.1001-5256.2016.04.012

超声引导下经皮肝穿刺注射华蟾素与无水乙醇治疗门静脉癌栓的效果比较

DOI: 10.3969/j.issn.1001-5256.2016.04.012

解放军第九四医院

基金项目:

2013年江西省卫生厅中医药科研基金课题(2013A044)；

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2345
- HTML全文浏览量: 16
- PDF下载量: 444
- 被引次数: 0
出版历程
- 出版日期: 2016-04-20

Effect of ultrasound- guided percutaneous injection of cinobufotalin or anhydrous ethanol in treatment of portal vein tumor thrombus: a comparative analysis

The 94th Hospital of PLA

Research funding:

摘要

摘要:
目的对比观察超声引导下经皮肝穿刺注射华蟾素与注射无水乙醇治疗门静脉癌栓的疗效。方法选取2009年10月-2011年12月解放军第九四医院收治的56例肝癌术后复发的门静脉癌栓患者,其中27例行超声引导下经皮肝穿刺华蟾素注射治疗（华蟾素组）,29例行超声引导下经皮肝穿刺无水乙醇注射治疗（无水乙醇组）。对比2组患者的临床疗效及生存期,并比较其治疗前后的TBil、ALT、AST水平。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,等级资料比较采用Mann-Whitney U检验,生存分析采用Kaplan-Meier法。结果华蟾素组治疗后的有效率为63.0%,无水乙醇组58.6%,2组差异无统计学意义（χ2=0.111,P>0.05）;华蟾素组治疗后的TBil、ALT和AST水平均低于无水乙醇组,差异均有统计学意义（t值分别为2.24、2.40、2.39,P值均<0.05）;华蟾素组6个月、1、2年生存率分别为81.5%、63.0%、29.6%;无水乙醇组分别为82.8%、58.6%、31.0%,2组差异均无...
- 肝肿瘤 /
- 肿瘤循环细胞 /
- 门静脉 /
- 华蟾素 /
- 乙醇
Abstract:
To investigate the effect of ultrasound- guided percutaneous injection of cinobufotalin or anhydrous ethanol in the treatment of portal vein tumor thrombus( PVTT) through a comparative analysis. Methods A total of 56 patients with PVTT after liver cancer surgery,who were admitted to the 94 th Hospital of PLA from October 2009 to December 2011,were enrolled. Among these patients,27 underwent ultrasound-guided percutaneous injection of cinobufotalin( cinobufotalin group) and 29 underwent ultrasound- guided percutaneous injection of anhydrous ethanol( anhydrous ethanol group). The clinical outcome and survival time were compared between the two groups after treatment,and the levels of total bilirubin( TBil),alanine aminotransferase( ALT),and aspartate aminotransferase( AST) before and after treatment were compared. The t- test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,the rank sum test was used for comparison of ranked data,and the Kaplan- Meier method was used for survival analysis. Results The response rate showed no significant difference between the cinobufotalin group and the anhydrous ethanol group( 63. 0% vs 58. 6%,χ~2= 0. 111,P > 0. 05). After treatment,the cinobufotalin group had significantly lower levels of TBil,ALT,and AST than the anhydrous ethanol group( t = 2. 24,2. 40,and 2. 39,all P < 0. 05). The 6- month,1- year,and 2- year survival rates showed no significant differences between the cinobufotalin group and the anhydrous ethanol group( 81. 5% /63. 0% /29. 6% vs 82. 8% /58. 6% /31. 0%,χ~2= 0. 016,0. 111,and 0. 013,all P > 0. 05). Conclusion Ultrasound- guided percutaneous injection of cinobufagin or anhydrous ethanol has similar short-and long- term effects in the treatment of PVTT and can inhibit the growth of tumor thrombus and prolong survival time,but cinobufagin is superior to anhydrous ethanol in the aspect of protecting liver function.
- liver neoplasms /
- neoplasm circulating cells /
- portal vein /
- cinobufagin /
- ethanol

HTML全文

参考文献(15)

[1]HAN K,KIM JH,KO GY,et al.Treatment of hepatocellular carcinoma with portal venous tumor thrombosis:a comprehensive review[J].World J Gastroenterol,2016,22(1):407-416.

[2]SHI J,LAI EC,LI N,et al.A new classification for hepatocellular carcinoma with portal vein tumor thrombus[J].J Hepatobiliary Pancreat Sci,2011,18(1):74-80.

[3] YANG X,YUAN GB,WANG YC,et al.Clinical value of125Iseeds implantation combined with high intensity focused ultrasound for the treatment of portal vein tumor thrombus from hepatocellular carcinoma[J].Chin J Nucl Med Mol Imaging,2015,35(3):182-185.(in Chinese)杨鑫,袁耿彪,王玉婵,等.125I粒子植入联合高强度聚焦超声治疗肝癌门静脉癌栓的临床价值[J].中华核医学与分子影像杂志,2015,35(3):182-185.

[4]CHEN P,LI F.New progress in treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].J Clin Hepatol,2015,31(6):974-976.(in Chinese)陈鹏,李菲.肝细胞癌合并门静脉癌栓治疗新进展[J].临床肝胆病杂志,2015,31(6):974-976.

[5]XU JF,LIU XY,WANG S,et al.Surgical treatment for hepatocellular carcinoma with portal vein tumor thrombus:a novel classification[J].World J Surg Oncol,2015,13(1):86.

[6]QUIRK M,KIM YH,SAAB S,et al.Management of hepatocellular carcinoma with portal vein thrombosis[J].World J Gastroenterol,2015,21(12):3462-3471.

[7]GAO Y,ZHU H.Research progress of high intensity focused ultrasound in the treatment of portal vein tumor thrombus[J].Chongqing Med,2014,43(13):1641-1643.(in Chinese)高艳,朱辉.高强度聚焦超声治疗门静脉癌栓的研究进展[J].重庆医学,2014,43(13):1641-1643.

[8]JI JF,DENG XL,XIAO QJ,et al.Percutaneous cinobufotalin injection under ultrasonography combined with transcatheter arterial chemoembolization on treating portal vein tumor thrombus[J].JChangchun Univ Chin Med,2015,31(5):1059-1062.(in Chinese)冀建峰,邓晓莉,肖秋金,等.超声介入华蟾素联合肝动脉化疗栓塞治疗门静脉癌栓[J].长春中医药大学学报,2015,31(5):1059-1062.

[9]LIVRAGHI T,GRIGIONI W,MAZZIOTTI A,et al.Percutaneous alcohol injection of portal thrombosis in hepatocellular carcinoma:a new possible treatment[J].Tumori,1990,76(4):394-397.

[10]ZHANG XJ,LIN LW,XUE ES,et al.Uitrasound-guided percutaneous ethanol injection in the treatment of hepatocellular carcinoma combined with portal vein tumor thrombosis[J].Chin J Interv Imaging Ther,2011,8(5):367-370.(in Chinese)张秀娟,林礼务,薛恩生,等.超声引导经皮无水乙醇注射治疗肝癌伴发门静脉癌栓[J].中国介入影像与治疗学,2011,8(5):367-370.

[11]XING FJ,LI L,ZHOU ZY.Professor Zhou Zhong-ying's experience on the treatment of liver cancer by complex decoction[J].Jilin J Tradit Chin Med,2014,34(1):22-25.(in Chinese)邢风举,李柳,周仲瑛.周仲瑛教授应用复法大方治疗肝癌[J].吉林中医药,2014,34(1):22-25.

[12]WANG TT,XU GX.Advancement on study of pharmacological action and clinical application of cinobufotalin[J].Int J Ophthalmol,2009,9(7):1330-1333.(in Chinese)王婷婷,徐国兴.华蟾素的药理作用研究及临床应用进展[J].国际眼科杂志,2009,9(7):1330-1333.

[13]JIANG YF.Pharmacological effects and clinical adverse reactionsof cinobufagin[J].China J Chin Med,2011,26(9):1082-1083.(in Chinese)姜玉凤.华蟾素注射液的药理作用及临床不良反应[J].中医学报,2011,26(9):1082-1083.

[14]ZHAO ZG,TANG ZQ.The clinical value of cinobufacini injection care for liver cancer[J].Inner Mongolia Med J,2015,47(2):172-175.(in Chinese)赵直光,唐中权.华蟾素注射液治疗肝癌的临床应用价值[J].内蒙古医学杂志,2015,47(2):172-175.

[15]SHEN JJ,TAN SZ.Transcatheter arterial embolization with cinobufacini on terminal stage of hepatocellular carcinoma[J].Jilin J Tradit Chin Med,2015,35(7):678-680.(in Chinese)沈建军,谭善忠.华蟾素联合TACE治疗中晚期肝癌[J].吉林中医药,2015,35(7):678-680.

施引文献

资源附件(0)

访问统计