How is the hepatocarcinoma patient chosen the healing solution according to the condition? 's treatment

How is the hepatocarcinoma patient chosen the healing solution according to the condition? 's treatment
Primary hepatocarcinoma ' Play and weigh hepatocarcinoma) The patient should be chosen the best scheme according to detailed conditions of pathological change and characteristics and adaptation cards of different therapeutic method. Should be according to size and number of tumour, position and range, intravenous cancer bolt and distant place that tumour attacks shift situation, patient's liver function and compensate intensity and whole body state and weigh the decision in an all-round way. Further standardize the treatment of hepatocarcinoma, confirm the best first-selected scheme and comprehensive healing solution for the patient, in order to improve the overall curative effect of hepatocarcinoma, it is the important subject of clinical research of present hepatocarcinoma.
Surgery of first, hepatocarcinoma standardizes the treatment
It is hepatocarcinoma treatment most effective radical cure means and first-selected method at present that the liver excises the skill. Until can the first stage of hepatocarcinoma that excise should in time competent excision of effecting a radical cure etc.. Hepatocarcinoma patient's many companion's liver cirrhosis or chronic hepatitis, effecting a radical cure liver tumour of excision of the irregular part can keep normal liver to organize to the maximum extent, help, recover while being postoperative, improve the excising rate of hepatocarcinoma, reduce the mortality of operation, its long-term curative effect is the same as systematicness excision too. Expanding surgical indication constantly too, while accompanying the cancer bolt in the cancer bolt or bile duct of portal vein as to hepatocarcinoma, so long as tumour may be excised, should be positive the surgery treatment. Amalgamate spleen excising and blanking skill of doing while hepatocarcinoma is excised of high pressure of the serious portal vein, also make the satisfactory result. As to ascertain by surgery or image learn, check, verify enormous tumour or press close to trunk difficult person who effect a radical cure excision person can adopt the condoning surgical treatment not excised ' If liver artery ligature adds part treatments such as freezing or microwave treatment,etc.) in the chemotherapy of intubate, skill Perform the operation treatment ' With liver artery chemotherapy thromboembolism in order to choose first) ,Do after the tumour volume obviously dwindles two excise, enable some hepatocarcinoma can't cure, change into, can partly cure, its long-term curative effect is superior to the first stage of condoning excision. And relatively loud for tumour ' The diameter is greater than 8cm) And a plurality of hepatocarcinoma of tubercle, make membrane to be already incomplete often, and sow in liver scatteredly more and the portal vein cancer bolt exists, excise more for excision of condoning etc. while being the first stage of, often difficult to remove tumour completely, may accelerate to broadcast because of stimulus that liver excise scattered and shifting incomplete cancer while being postoperative. For condoning patient of excisions,postoperative should positive for treatments antitumor,last growth of tumour, further lengthen a patient to take tumour to survive for time. To the patient who can not excised, should adopt complex treatment actively. The postoperative hepatocarcinoma patient should treat synthetically, prevent the recurring of hepatocarcinoma. For reduce, excise, recur while being postoperative, must pay attention to, have the intersection of tumour and principle in the skill, operation it operates to be should carefully, avoid excessively pushing somely, reduce and cure source diffusion, do the best to guarantee to cut reason in capacity, remove the cancer bolt completely. Because it has small focus and portal vein cancer bolt how hepatocarcinoma perimeter liver is organized, so part excise cut reason should body 1.5cm the above-mentioned from tumour. Should reexamine regularly while being postoperative, if there is incomplete cancer or recur and should be treated in time. Check and right amount of chemotherapy thromboembolism in artery radiography of postoperative feasible liver, in order to find with the residual focus of treatment and shift the cooking stove in early days, the persons who have not found the focus also do benefit to removing the tumour cells that may be remaining. The postoperative hepatocarcinoma that recured for excising, all the person who has condition should try to perform the operation and excise actively, focus dark, occur frequently and the intersection of liver function and bad patient can adopt, perform the operation treatment.
Liver transplantation suitable for light hepatocarcinoma amalgamate serious patient of liver cirrhosis, intravenous the intersection of cancer and bolt, sow scatteredly in the liver, or the person who shifts organ should be classified as the taboo outside the liver. The long-term curative effect of liver transplantation is superior to the liver and excise the skill. It is unsuitable to be regarded as the conventionally therapeutic choice at present.
Second, hepatocarcinoma perform the operation to standardize the treatment non-
Only about 20% of hepatocarcinoma patients can obtain the operation to excise at present, and the recuring rate of five years after the operation is up to 60%- 80%. For most hepatocarcinoma, especially in later period patient,it is last important therapeutic method still to perform the operation by treatment.
Liver artery chemotherapy thromboembolism (TACE) Suitable for hepatocarcinoma that can't excise, take right leaf as the core or the intersection of frequently-occurring disease and cooking stove, or recur but can't perform the operation persons who excise while being postoperative mainly. It is the important means to improve curative effect of hepatocarcinoma that the effecting a radical cure postoperative excision of hepatocarcinoma adopts the positive intervention treatment to prevent from recuring. Liver cancer cell that the effecting a radical cure excision postoperative TACE of hepatocarcinoma may be remaining when can further remove the liver, reduce and recur the recurring rate of the peak period. But to sowing the scattered satellite cooking stove and curative effect of the portal vein cancer bolt limitedly, it is more difficult to control the focal distant place to shift, and can't block the emergence of hepatocarcinoma. In order to achieve the goal of preventing and curing for a long time, need to treat and unite application with other therapeutic method especially living beings. To the condoning postoperative incomplete cancer of excision or effecting a radical cure case that can't be excised any more of recuring of postoperative excision, TACE is still one of the first-selected therapeutic method.
Ultra acoustic conductance guide, down, puncture by skin injection treat in the tumour, security high and bad reaction slight can go on repeatedlying, among them anhydrous ethanol is injected (PEI) Have already employed in clinic extensively, suitable for the diameter 5cm of tumour, focus exceed 3 generally and tumour locate adjacent liver door department trunk and whole body to excise, recur while being postoperative, can't tolerate patient of surgery. As to the primary hepatocarcinoma under the diameter 3cm, because organize the composition to be single, with complete ethanol disperse, its curative effect approaches the operation to excise, some cases can be radically treated the result. Big hepatocarcinoma often has tumours that wraps up the membrane is soaked or the blood vessel is infringed, should be with other treatments (TACE,etc.) Combine application. Second sour( 15%- 50%) Have stronger infiltration ability of organization than anhydrous ethanol, the fiber apt to penetrate cancer while organizing separates by but even disperse, it injects the number of times and injects the total amount to obviously reduce. Hot brine or distilled water can pour into than heavy dose of used in big treatmenting of hepatocarcinoma. But the temperature in the tumour cooking stove is difficult to control and influence curative effect directly at the time of practical application, and injecting the high pressure produced in a large amount may cause the cancer cell to spread, should pay attention to.
Punctured the radio frequency in tumour by the cover and melted to treat (RFA) Suitable for diameter under the 3cm mainly, focus counts lt; 4, having no hepatocarcinoma shifted outside cancer bolt or liver of portal vein, its complete necrosis rate of tumour can be more than 90%, close to the operation and excise curative effect. In tumour injection is anhydrous for ethanol it last blood and support and inject high to ooze or,etc. if you can't ooze by brine, expand to can last curative effect to last range, can also jointly employ treating big hepatocarcinoma with liver artery thromboembolism. Punctured the diameter lt correctly of microwave solidification treatment in tumour by the cover; Hepatocarcinoma of 2cm can often reach complete necrosis, but unsuitable to treat close to tumour around the gallbladder, diaphragm skin or trunk. To the diameter gt; 3cm person can adopt large stitch puncture and some make radiation up in order to mention more
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