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保持传统优势手术 微创介入“双管齐下”
2017-08-23 10:02:34 中国青年网
袁林所带领的团队为他制定了“规范化肿瘤切除+术后经肝动脉插管化疗栓塞(TACE介入)”的综合诊疗方案:将他的右肝叶Ⅵ、Ⅶ、Ⅷ三段切除,术后进行介入化疗,让药物直达肝脏,配合清扫残余病灶。出院后,李先生遵循袁主任制定的抗乙肝及免疫方案进行治疗,随诊半年来没有发现残存病灶,身体状况和生活质量都有了明显提高。“肝癌虽有癌中之王的称号,但也并不完全等于死刑。”袁林说。
袁林提醒,在罹患肝癌的人群中,80%左右都是有乙肝病史的病友。有肝炎病史的市民,一定要坚持抗肝炎治疗,每半年或一年做一次肝脏B超探查。一旦及早发现肿瘤,及时行“外科手术+综合性治疗”,从目前来看,预期效果都还比较好。如果肝脏部位有残余或是发现微小残余病灶,可通过TACE用药进行局部精准化疗。
血管介入
为肿瘤和周围血管病“护航”
“微波和射频消融治疗,对延长肿瘤病人的生存周期,提高生存质量效果也很显著。”袁林告诉记者,目前已经有近百位患者受益。
今年4月,83岁的李太婆因胆石症住院。B超探查时发现,她的肝上有个3公分的肿瘤。袁林考虑到她年龄大,手术耐受性差,与病人家属反复沟通后,决定给她做介入消融。经B超定位,微波消融将李太婆肝脏肿瘤定位击毁,半个小时就完成了手术。前段时间,李太婆来复查,肝脏内没有发现残余和转移病灶。
袁林主任介绍,临床观察发现,肝脏肿瘤小于5公分,最好在3公分以下,通过微波射频可以达到跟手术同期的效果。
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