摘要
目的探讨双侧膀胱动脉和/或髂内动脉化疗栓塞治疗膀胱癌出血的应用价值。方法回顾性分析2009年1月-2012年3月收治的19例膀胱癌合并血尿患者行动脉化疗栓塞术治疗的临床资料。采用超选择性动脉插管技术,对19例膀胱癌出血者行经皮双侧膀胱动脉和/或髂内动脉插管化疗栓塞治疗,并对术后血尿情况、并发症进行观察和随访。结果双侧髂内动脉造影,动脉期可见肿瘤的供血动脉常增粗、血管侵蚀、中断及紊乱的肿瘤血管,实质期可见肿瘤染色。19例(100%)患者在栓塞术后24 h内肉眼血尿不同程度减轻,2 d后出血停止16例(84.2%),出血减少3例(15.8%),其中2例经保守治疗后止血,1例失败,再次行栓塞治疗后出血停止。术后无严重不良反应。结论膀胱癌并发血尿患者,双侧膀胱动脉和/或髂内动脉化疗栓塞治疗是一种安全、有效的方法。
Objective To evaluate the value of bilateral bladder artery and/or internal iliac artery chemoembolization for the hemorrhage of bladder cancer.Methods Clinical data of arterial chemoembolization in 19 patients with hematuria of bladder cancer from January 2009 to march 2012 were analyzed retrospectively.19 cases of hemorrhage of bladder cancer were treated by bilateral bladder artery and/or internal iliac artery chemoembolization.Postoperative hematuria and complications were observed and follow-up was done in all patients.Results The internal iliac artery angiography showed the thickening tumor feeding artery,vascular erosion or disruption,and disorder of tumor blood vessels in the arterial phase,and tumor staining in the parenchymal phase.The gross hematuria decreased after embolization within 24 h in all 19 patients;Hematuria stopped within 2 days in 16 cases;Hematuria decreased after 2 days in 3 cases,Hematuria stopped after conservative treatment in 2 cases,1 case failed to stop bleeding and the bleeding was stopped after the embolization.No major complications related to catheterization occurred.Conclusion Chemoembolization through bilateral bladder artery and/or internal iliac artery is an effective and safe method for the bladder cancer with hematuria.
出处
《中华全科医学》
2013年第4期528-529,646,共3页
Chinese Journal of General Practice
关键词
膀胱癌
血尿
化疗栓塞术
介入放射学
Bladder cancer
Hematuria
Chemoembolization
Interventional Radiology
