摘要
目的观察应用新型明胶海绵微粒TACE术治疗原发性肝癌术后导致肝脓肿的发生率。方法 2009年6月—2012年8月,应用明胶海绵微粒行TACE术治疗原发性肝癌患者208例,观察TACE术后肝脓肿的发生情况,分析发生原因及机制,总结预防及治疗经验。结果 208例患者共行792次TACE术,每例平均手术3.8次,介入手术平均间隔时间为4.9个月,随访时间为2～34个月(平均13个月),术后共发生肝脓肿3例,发生率为0.38%,其中1例行经皮肝穿刺外引流术,生存期达25个月,另2例未行外引流术或抽吸术,围手术期内治疗无效死亡。结论明胶海绵微粒TACE治疗原发性肝癌术后肝脓肿并发症发生率低,对于高危因素人群给予积极预防措施,及早确诊及早引流能够降低致死率。
Objective To discuss the incidence of liver abscess that occurs after transcatheter arterial ehemoembolization （TACE） by using new-type gelatin sponge particles （GSPs） as embolic agent for the treatment of primary hepatic cancer （PHC）. Methods During the period from June 2009 to August 2012, TACE by using new-type GSPs as embolic agent was performed in 208 PHC patients at authors＇ institute. The occurrence of liver abscess after TACE was recorded. The causes and mechanisms of the postoperative liver abscess were analyzed, and the experience concerning its prevention and treatment was summarized. Results A total of 792 times of TACE procedure were accomplished in 208 patients with an average of 3.8 times for each patient. The mean interval between two TACE procedures was 4.9 months. The follow-up time ranged from 2 to 34 months with a mean of 13 months. Postoperative liver abscess occurred in three patients, the incidence of liver abscess was 0.38% （3/792）. Of the three patients, percutaneous transhepatic external drainage of the abscess was carried out in one, and the patient continued to live for 25 months. No external drainage or abscess aspiration was adopted in the other two patients, and the two patients died in perioperative period. Conclusion For the treatment of primary hepatic cancer, TACE by using new-type GSPs as embolic agent carries lower incidence of postoperative liver abscess. Active preventive measures should be taken in high risk patients. Earlier diagnosis and effective drainage can reduce the mortality rate. （J Intervent Radiol, 2013, 22：415-417）
出处
《介入放射学杂志》
CSCD
北大核心
2013年第5期415-417,共3页
Journal of Interventional Radiology
基金
辽宁省社会发展科技攻关项目编号(2012225020)
关键词
肝肿瘤
明胶海绵微粒
经导管肝动脉化疗栓塞术
肝脓肿
hepatic carcinoma
gelatin sponge particle
transcatheter arterial chemoembolization
liver abscess
