【摘要】 目的　探讨奥曲肽经肝动脉给药的安全剂量 ,以及小剂量奥曲肽联合肝动脉栓塞化疗对肝癌术后复发转移的预防作用。方法　 4 0例肝癌根治术后病人随机分为实验组和对照组 (各 2 0例 ) ,经肝动脉埋泵给药。实验组首日推注奥曲肽 2 0 0 μg,顺铂碘油混悬液 18ml(顺铂 4 0mg/ 8ml+超液化碘油 10ml)。次日再推注奥曲肽 2 0 0 μg。对照组 :仅于首日经肝动脉泵缓慢推注顺铂碘油混悬液18ml。每隔 4～ 8周重复给药一次。观察两组病人的化疗反应 ,并作短期术后随访以判定疗效。结果　实验组化疗反应发生率与对照组相仿 ,未出现明显的心、肝、肾等重要脏器损害。一过性脸部潮热伴或不伴全身潮热是奥曲肽经动脉给药的惟一反应。随访显示实验组 (对照组 ) 1年复发率、肝外转移率和死亡率分别为 2 5 % (45 % )、5 % (2 0 % )、10 % (2 5 % ) ,组间差异有统计学意义。结论　经肝动脉一次给予 2 0 0 μg奥曲肽是安全的 ,奥曲肽联合肝动脉栓塞化疗对预防肝癌根治术后近期复发转移有一定疗效 ,但对于术后远期的预防作用尚需进一步临床验证。更多还原

【Abstract】 Objective To explore the safe dosage of octreotide given through hepatic artery and investigate the prophylactic effects of remedy by combined use of octreotide and TACE on relapse and metastasis after radical operation for primary hepatocellular carcinoma (HCC). Methods Forty patients receiving radical excision were randomized into the study group and control group and were all given drugs through hepatic artery pump. For the study group, the first day’s dosage was octreotide 200 μg, mixture of CDDP and lipiodol 18 ml (CDDP 40 mg/8ml + superliquefied lipiodol 10 ml). The second day’s dosage was octreotide 200 μg. For the control group, only mixture of CDDP and lipiodol 18 ml was given on the first day. The remedy was repeated every 4-8 weeks. Then we observed their side effects and conducted a short-term follow-up study. Results The side effects were similar between the two groups. There were no obvious damages in important organs such as heart, liver and kidney. Face hectic fever with or without total body hectic fever was the only and transient reaction to administration of octreotide through the artery. Follow-up study showed that 1-year relapse rate, extrahepatic metastasis rate and mortality were 25%, 5% and 10% in the study group but 45%, 20% and 25% in the control. There were significant differences between the two groups. Conclusions Administration of 200 μg octreotide through the hepatic artery is safe. The remedy by combined use of octreotide and TACE is effective for prevention of relapse and metastasis after radical operation in a short period of time.更多还原