临床误诊误治2018，Vol.31Issue(1)：1-5,5.DOI:10.3969/j.issn.1002-3429.2018.01.001
肝癌伴肝功能不全患者的介入治疗:策略与哲学思想
Chemoembolization for Liver Cancer Patients with Decompensate Liver Function:Strategy and Philosophy
摘要
Abstract
Liver cancer with decompensated liver function is conventionally contraindication for chemoembolization. Liver dysfunction including jaundice, alanine aminotransferase elevation, hypoproteinemia with ascites, hypersplenism with leukocyte and/or thrombocytopenia. Based on long-term practice, this paper proposes the strategy of chemoembolization for liver cancer patients with decompensated liver function. Firstly, modify the chemoembolization method ( Dose-reduced chemo-embolization) ,which means reduce the dose of chemotherapeutic drugs and the dosage of embolic agent remains normal. Sec-ondly, differential the causes of liver dysfunction, such as obstructive jaundice caused by tumor compression and elevated ala-nine aminotransferase caused by tumor. For patient like these, chemoembolization should be the first choice, rather than re-duce the jaundice or protect the liver function. For patients with ascites caused by hypoproteinemia, leukopenia and/or throm-bocytopenia caused by hypersplenism, the first issue is control the tumor rather than adjuvant therapy.关键词
肝肿瘤/肝功能不全/放射摄影术,介入性/化学疗法,肿瘤,局部灌注Key words
Liver neoplasms/Hepatic insufficiency/Radiography/interventional/Chemotherapy/cancer/regional perfusion分类
医药卫生引用本文复制引用
夏景林..肝癌伴肝功能不全患者的介入治疗:策略与哲学思想[J].临床误诊误治,2018,31(1):1-5,5.基金项目
上海市新百人项目(XBR2011002) （XBR2011002）
上海市优秀学科带头人项目(14XD1401100) （14XD1401100）
国家自然科学基金面上项目(81272732) （81272732）
