Liver Intervention

　　Cancer cells mainly invade the liver through the circulatory system. The liver is an organ with a large blood flow, and there are two systems in the human body that supply blood to the liver. The first is the portal vein system, where the venous blood of all abdominal organs including the stomach, small intestine, colorectal, pancreas, and spleen collects in the portal vein and then returns to the liver. It sends the nutrients absorbed to the liver for the synthesis of various substances necessary for the human body and detoxifies the toxins produced by human metabolism. At the same time, the primary malignant tumor cells of these organs can also flow directly to the liver through this route and then stay in the liver to form metastatic tumors. The second blood supply system of the liver is the hepatic artery system, where fresh oxygen-rich blood supplied by the heart flows into the liver through the aorta, celiac trunk artery, common hepatic artery, and proper hepatic artery.

　　另外像胆囊、胃、肾上腺和胆管这类与肝脏位置邻近、关系密切的器官，但其原发恶性肿瘤长到一定程度后，很容易向肝脏这个“老邻居”直接扩散，形成所谓的浸润转移。

　　恶性肿瘤长到直径大于2厘米时，每天可释放大量的癌细胞进入血液循环，这些癌细胞通过“随波逐流”最终都可以到达肝脏。肝脏的结构就像一块厚实的浸满血的海绵，血液灌流量较大而流速较慢，肿瘤细胞易于进入肝脏实质并停留下来。其中到达肝脏的恶性度较高的肿瘤细胞可分泌某些生长因子促进自身瘤细胞的增殖，并刺激周围新生毛细血管长入，因此逐渐形成独立的肿瘤细胞团块，用不了很长时间就可以形成肉眼可见大小的肿瘤转移病灶了。

　　常并发多系统器官衰竭.主要并发症的发病率以肾功能衰竭（简称肾衰）最高（23.14％），其次依次为呼吸功能衰竭（简称呼衰）（14.88％），肝功能衰竭（13.22％），循环衰竭（9.92％）和弥漫性血管内凝血（DIC）（3.31％）。多器官功能衰竭的病死率为94.4％，明显高于单器官衰竭的病死率（33.3％）。AOSC并发器官功能衰竭的病死率为79.2％。AFC时并发多系统器官功能衰竭是最主要的死亡原因。

　　绝大多数肝癌患者都是在晚期发现自身病情的存在的，通常是因为肝癌起病隐匿，不易被察觉。那么，肝癌晚期患者都有哪些症状存在呢。

　　1、消化道症状：这一肝癌的症状往往伴随着肝癌患者的整个病程，一般会呈现消化不良、食欲下落、恶心、恶心、腹胀等多种症状，易被误以为慢性肠炎，因此我们要实时进行肝癌的检查，防备误诊的呈现。

　　2、消瘦乏力：晚期肝癌的症状另有消瘦乏力，能够因为消化功用杂乱、营养吸取停滞致使能量不敷，严峻时呈现恶病质，影响康健；下肢水肿也是肝癌的晚期症状之一。

　　3、恶性腔积液：恶性腔积液是重要的和恶性肿瘤疾病，症状发生肝癌晚期恶性腔积液，如果处理不当，会导致迅速恶化并导致死亡，所以患者们要注意定期进行肝癌的检查，避免这种情况的发生。

　　4、胸腔转移：肝癌晚期症状中会发现胸腔转移的症状，胸腔转移以右侧多见，可有胸腔积液征。同时，伴随这一肝癌症状的还有骨骼或脊柱转移，可有局部压痛或神经受压症状，颅内转移癌可有神经定位体征。这些转移症状都会在肝癌晚期表现出相应的症状。

　　5. Respiratory disorders:Respiratory difficulties in the late stages of liver cancer are often caused by lung metastasis, and severe respiratory difficulties can easily cause fear and, if not treated promptly, can lead to sudden death.

　　6. Liver coma:Among the symptoms of advanced liver cancer, the most undesirable is the liver coma symptoms. During the treatment of liver cancer, there may be gastrointestinal bleeding, secondary infection, excessive diuretics, and electrolyte imbalance, which often lead to liver coma, so special attention should be paid to liver cancer.

　　1. Drink more water

　　In early spring, the cold and dry weather is prone to dehydration, so drinking more water can replenish body fluids, enhance blood circulation, promote metabolism, and is also beneficial for digestion and absorption, as well as the elimination of waste, reducing the damage to the liver from metabolic products and toxins.

　　2. Drink less alcohol

　　In early spring, when the cold is strong, a small amount of alcohol is beneficial for promoting blood circulation, removing blood stasis, and boosting the Yang of the liver. However, one should not drink excessively, as the liver's ability to metabolize alcohol is limited, and excessive drinking will definitely harm the liver!

　　3. Balanced diet

　　Maintain a proper balance of protein, carbohydrates, fats, vitamins, and minerals in food; at the same time, maintain a balanced taste; try to eat less spicy food and more fresh vegetables and fruits; do not overeat or under-eat.

　　4. Maintain a cheerful mood

　　Since the liver likes to be relaxed and dislikes depression, anger and frustration can easily lead to stagnation of Qi and blood in the liver, resulting in disease. Firstly, one must learn to control anger, try to remain calm and optimistic, so that the liver fire is extinguished, and the liver Qi is normally generated and flows smoothly.

　　5. Moderate exercise

　　In spring, engage in outdoor activities suitable for the season, such as walking, going for a picnic, playing sports, practicing Tai Chi, etc., which can not only ensure the smooth flow of Qi and blood in the body, promote the elimination of waste, strengthen the body, but also soothe the liver, achieving the purpose of liver protection and health maintenance.

　　6. Wear loose clothing

　　Loose clothing, loose hair, and a relaxed posture allow for the free flow of Qi and blood, preventing stagnation. With smooth Qi and blood in the liver, the body will naturally be strong.

　　Liver interventional therapy refers to the regional and local chemotherapy by injecting anticancer drugs or embolic agents into the hepatic artery through catheterization of the femoral artery. It is currently the preferred method for non-invasive surgical treatment of liver cancer. Liver interventional therapy is simple and easy to perform, safe and reliable, and can be performed in the elderly, the weak, and those with certain diseases, making it very popular. Before undergoing interventional therapy, several preparations are usually required:

　　1. Preoperative assessment

　　Preoperative assessment includes understanding the location, number, and size of the liver cancer lesions, and it is recommended to undergo a CT scan, which can provide a very comprehensive analysis of the lesions. Additionally, the patient's physical condition is also one of the main contents of the assessment, including coagulation function, cardiovascular and respiratory function, liver and kidney function, etc.

　　2. Preoperative preparation

　　Preoperative preparation includes iodine allergy test. Inject 1 mL of 30复方泛影葡胺 through the Shenmai meridian and observe for dizziness, nausea, vomiting, palpitations, measles, and other allergic reactions within 15-20 minutes. Prior to surgery, it is necessary to prepare the perineum. Abstain from food and water for 4 hours before surgery and try to empty the bowels and bladder as much as possible.

　　1. For nausea and vomiting, ginger can be taken, and a non-irritating, easy-to-digest diet should be given, with small meals and frequent eating. Try to take care of their original eating habits, with food temperature appropriate; do not drink too much water while eating. The eating speed should be slow; do not lie flat for half an hour after a meal, and avoid greasy or fried foods.

　　2. Severe vomiting patients can be given antiemetics, and a few drops of ginger juice can be dropped on the tongue before eating, waiting for a moment before eating. If necessary, full parenteral nutrition support can be provided.

　　3. Abdominal pain patients can add a moderate amount of sesame oil and vinegar to the vegetables they eat, which has analgesic effects.

　　4. Severe ascites patients should limit water intake, be given a low-sodium diet, and avoid preserved foods. Sugar and vinegar cooking methods can be used to adjust the taste.

　　5. Patients with jaundice can eat lily, luffa, water chestnut, sesame oil, and other adjuvants to help reduce jaundice.

　　6. When there is decompensation of liver cirrhosis, high-quality protein should be given, with a limit of 75g per day.

　　7. Patients with high blood ammonia levels should limit or avoid protein intake, and the source of heat should be mainly carbohydrates, such as fresh fruits and vegetables.

　　8. Feverish patients should drink plenty of water to promote heat dissipation.

　　9. Patients with frequent vomiting should temporarily fast to avoid stimulating the stomach with food, increasing the frequency of vomiting, and consuming physical strength.

　　10. Patients should be given a low-protein diet, with a total protein intake of 20-40g per day, and it is best to choose animal proteins with high physiological value, such as milk, eggs, and lean meat.

　　Under the supervision of the DSA angiography machine, the patient lies on their back, and the doctor uses a sharp blade to peel open the skin 2mm along the skin creases. The improved Seldinger puncture technique is used to puncture the side femoral artery and insert a catheter to selectively introduce a 5F or 4Fcobra catheter into the ipsilateral profunda femoral artery, superficial femoral artery, and obturator artery.

　　Under the monitoring of DSA digital imaging, the specific condition of the patient's lesion will be displayed on the screen in a three-dimensional stereoscopic image. Experts can clearly see the surrounding tissue condition and blood distribution through the screen, thereby safely and accurately determining the required treatment site.

　　After finding the treatment site, the treatment drugs can be directly delivered through the DSA catheter. Small-area precise treatment can continuously ensure the drug concentration at the treatment site, thereby achieving the purpose of long-term effective treatment.