摘要
目的：探讨肝动脉内植入药盒导管系统（ＰＣＳ）的最佳径路。材料与方法：２１６例中晚期肝癌，１１８例采取经皮左锁骨下动脉（ＬＳＡ）径路肝动脉内植入ＰＣＳ，另外９８例采取经皮股动脉（ＦＡ）径路植入ＰＣＳ。统计两种植入方法的成功率、并发症。结果：ＬＳＡ组与ＦＡ组植入成功率分别为９１．５％和８８．７％（Ｐ＞０．０５）。ＬＳＡ组植入失败的１０例为动脉穿刺失败８例，靶动脉迂曲留置管无法置入２例；ＦＡ组失败１１例均为留置管无法植入靶动脉内，其中腹腔动脉干过长５例，肝右动脉（靶动脉）起自肠系膜上动脉３例，靶血管迂曲３例。ＬＳＡ组气胸４例，留置管移位１２例，而ＦＡ组留置管移位１１例。移位率分别为１０．２％和１１．２％。结论：常规采取ＦＡ径路肝动脉内植入ＰＣＳ安全可行。对腹腔动脉、肝动脉解剖变异者采取ＬＳＡ法能够提高植入术成功率。
Objective: To study
the optimum access for hepatic arterial portcatheter system (PCS) implantation. Materials and
Methods: Of 216 advanced liver cancer patients treated with hepatic arterial PCS, 118 cases
were performed via left subclavian artery (LSA group) and the other 98 cases via femoral artery
(FA group). The success rate and complications were analyzed. Results: Success rate in LSA
group and FA group was 91.5% and 88.7% ( P >0.05), respectively. The surgery was
unsuccessful in 10 cases from LSA group due to puncture failure ( n =8) and tortuous target
artery ( n =2), and in 11 cases from FA group due to tortuous target artery ( n =3), extra long
celiac trunk ( n =5) and aberrant hepatic artery originating from SMA ( n =3). Dislocation of the
catheter tip was encountered in 12 cases of LSA group (10.2%) and in 11 cases of FA group (11.
2%). Pneumothorax happened in 4 cases of LSA group. Conclusion: Hepatic arterial PCS
implantation via FA is a safe and reliable technique for the treatment of advanced liver cancer.
PCS implantation via LSA should be used when celiac or hepatic variations exist.
出处
《临床放射学杂志》
CSCD
北大核心
1999年第5期302-304,共3页
Journal of Clinical Radiology
关键词
肝肿瘤
介入性放射学
导管留置
Neoplasm,liver Radiology, interventional Catheter,indwelling Evaluation study
