摘要
目的：研究以无水乙醇碘油乳剂作栓塞剂，行肝节段动脉栓塞术治疗原发性肝癌。材料和方法：观察４例无水乙醇碘油乳剂选择性栓塞正常狗肝动脉前后的门脉血流动力学改变。采用同一栓塞剂，行肝节段动脉栓塞术治疗原发性肝癌患者３４例。依肿瘤的类型、血供特点分别采用３种不同的栓塞技术：同轴导管法、直接法或药物辅助法。结果：实验性肝动脉栓塞后，门脉造影表现出局部门脉分支的阻塞性改变。镜下见肝实质内栓塞剂沉积区域的门脉分支内有滴状的无水乙醇碘油乳剂。临床治疗３４例后均无严重并发症出现，随访３～１８个月，２４例非手术患者中有６例出现局部复发，目前尚存活２１例；１０例患者接受二期手术，术后病检４例肿瘤完全坏死，其余６例包括子灶、包膜浸润癌灶均可见明显坏死，均未发现弥漫性肝损害。结论：行肝节段动脉栓塞术，能使肿瘤所在部位达到动门脉双重栓塞，且并发症少，对于病灶局限的原发性肝癌是一种很好的治疗手段。
Purpose:Toevaluatetheeficiencyofsegmentaltransarterialembolization(segmen-talTAE)withethanoliodizedoilemulsion(EIOE)inthetreatmentofprimaryhepaticcarcinom.MaterialsandMethods:Thehemodynamicchangesofportalveinafterintra-arterialinfusionofEIOEwerestudiedinfourdogs.SegmentalTAEusingEIOEwascariedoutin34patientswithprimaryhepaticcarcinoma.Acordingtothetypeandbloodsupplyofthetumor,threediferentmethodswereusedforsuperselectiveembolization:(1)coaxialcathetermethod;(2)usingextrasmoothTeru-moguidewireandYashirocatheter;(3)injectionofepinephrineintothesupplyingarteryofthetu-morfolowedbysegmentalTAE.Results:Theembolizationofportalveinbranchesintheliverofthehealthydogswasobserved,ifEIOEwasinjectedintothehepaticarteryatdosesaboveacertainlevel,dropletsofEIOEweremicroscoplyrevealedintheportalveinbranchesinthevicinityofEIOEacumulationinparenchyma.Duringthefolow-upperiod(range3～18months)localrecurenceaf-terinitialsegmentalTAEwasobservedin6of24patientswhodidnotunderwentsurgicalresectionofthetumor.Twenty-oneofthese24patientsarestilalive.Noseriouscomplicationsaftersegmen-talTAEwerenoted.Tenpatientssubsequentlyunderwentsurgery.Inpathologicalexaminationofthespecimen,completenecrosiswasfoundinfour,andextensivenecrosiswasobservedintheother6tumorsintheinvadedcapsuleanddaughternodules.Noseveredamageoftheliverwasfound.Conclusion:SegmentalTAEusingtheabovedescribedtechniquemightleadtobotharterialandpor-talveinembolizationinthetumor-bearingsegmentswithoutremarkablecomplications.Itcouldim-provetheefectsofTAEandwasausefultherapeuticmethodforhepatocelularcarcinomalocalizedtooneorafewsegmentalregionsoftheliver.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1996年第2期85-89,共5页
Chinese Journal of Radiology
关键词
肝肿瘤
肝动脉
栓塞术
LiverneoplasmsHepaticarteryEmbolization,therapeutic
