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1、TACE术联合氩氦刀冷冻消融治疗中晚期肝癌50例?l106?者,常规术前应用抗菌素治疗,雾化吸入及用呼吸功能训练器进行呼吸功能训练,由于右全肺切除后并发症出现率高,因此,对右全肺切除应持慎重态度.手术中在清扫肺门及纵隔内淋巴结时,避免损伤喉返神经,以免影响术后排痰J.术后重点保持呼吸道通畅,严格控制输液速度,根据血气分析的结果调整好水电解质平衡.MODERNONCOLOGY,Sept.2006,VoI.14,NO.9包内处理血管的方法,就只能放弃手术,因此,采用了从心包内处理血管全肺切除的方法,彻底切除了肿瘤.从表1可以看出,心包外全肺切除和
2、心包内处理血管全肺切除的术后并发症发生率并无明显差别(P>0.05).从两组病人的1,3,5年生存率来看亦无明显差别(P>0.05).因此,我们认为心包内处理血管全肺切除,不仅避免了手术意外大出血,又能完整切除肿瘤,明显扩大了手术适应症,提高了肺癌切除率,减少了开胸探察率,并且经系统性肺门纵隔淋巴结清扫],彻底切除侵犯心包及膈神经的肿瘤,从而达到根治肺癌的目的,手术安全可靠,明显改善了患者的生存质量,是治疗中心型肺癌的一种有效手段.【参考文献】[1】张大为,陈耀辉,毛龙生,等.支气管袖式(成型)肺叶切除治疗肺癌[J].中华外科杂志
3、,1993,31(3O):138～140.[2]远方量,许林,邱守雷.高龄支气管肺癌的外科治疗[J].中国肺癌杂志,2002,5(增刊):73.[3]吴一龙.肺癌多学科综合治疗的理论与实践[M].北京:人民卫生出版社,2000.195～198.[4]吴一龙,王思愚,黄植藩,等.I—IIIA非小细胞肺癌淋巴结清扫范围的前瞻性研究[J].中华肿瘤杂志,2001,23(1):43—45.TACE术联合氩氦刀冷冻消融治疗中晚期肝癌5O例练祖平,白广德,陆秀伟,黄丁平,侯恩存,关莹Treatmentof50caseswithadvancedhepato
4、cellularcarcinomabycombinationofTACEwithcryotherapyofemployingArgon/HeliumLIANZu—ping,BAIGuang—de,LUXiu—wei,HUANGDing—ping,HOUEn—cun,GUANYingDepartmentofOncology,RuikangHospitalofGuangxiTraditionalChineseMedicalUniversity,Nanning,Guangxi530011,China【Abstract】Objective:Toinv
5、estigatetheeffectandthesafetyofTACE(transcatheterhepaticarterialchemoemboli-zation)subsequentlycombined出cryotherapyofemployingArgon/Heliumfora~ancodhepatocellularcarcinoma.Methods:Fiftycaseswith~vancodhepatocellularcarcinomawerefirstreceivedTACEbymixediodineembolusa-gentfag
6、entultra—liquifiediodinizedoil1520ml+pingyangmycin8mg+DDP60mg+GEM800mg/m2+gelatinsp0"ge).CryotherapyofemployingArgon/HeliumbyCTwassubsequentlyperformed10—14dayslater.Onemonthafterthecombinedtreatment,AFP(alpha—fetoprotein)andliverCECT(contrastenhancementcomputedtomography)a
7、ndDSAwereexamined.Thefollow—uptimeWas12months.Results:In90.6%ofpatientswithAFPlevelupto400ng/ml,AFPvaluedecreasedmorethan50%AFPturnedintoinnegativein43.8%.Com-pletetumornecrosisWasobservedbyliverCECTandDSAin62.O%;incompletenecrosisin28.O%:partnecrosisin10.O%.The6一monthand12
8、一monthsurvivalrateswere94.O%and86.O%respectivelywithoutseverecompli-cationsinthetr
