摘要
目的探讨Embosphere微球联合碘油肝动脉栓塞治疗原发性肝癌破裂大出血的疗效。方法对25例肝癌破裂大出血,急症行Embosphere微球联合碘油肝动脉栓塞治疗,分析其疗效。结果肝癌破裂大出血25例,均为活动性大出血,Embosphere微球联合碘油介入手术栓塞止血成功24例,有效率为96%。术后平均动脉压由术前的(63.5±16.8)mmHg上升至(83.5±18.2)mmHg,与术前比较差异有统计学意义。术前ALT(141.3±77.8)u/L,术后5 d(170.1±98.6)u/L,术前总胆红素(21.3±7.1)μmol/L,术后5 d总胆红素(24.0±9.1)μmol/L,肝功能术前术后无差别。术后1、3、6、12个月生存率分别为92%(23/25)、84%(21/25)、72%(18/25)、48%(12/25)。结论 Embosphere微球联合碘油肝动脉栓塞治疗原发性肝癌破裂大出血止血效果显著,创伤小,为后续治疗创造条件。
Objective To evaluate hepatic artery embolization （HAE） with Embosphere microspheres （as an embolic agent） and Lipiodol in treating massive bleeding due to ruptured primary liver cancer. Methods Emergency HAE with Embosphere microspheres and Lipiodol was performed in 25 patients with massive bleeding due to ruptured primary liver cancer. The clinical results were analyzed. Results All the 25 cases had active massive bleeding due to ruptured primary liver cancer. After HAE with Embosphere microspheres and Lipiodol, successful hemostasis was obtained in 24 cases with an effective rate of 95%. After the treatment the mean arterial pressure rose from preoperative （63.5 ＋ 16.8） mmHg to postoperative （83.5 ＋ 18.2） mmHg, the difference was statistically significant （P 〈 0.05）. The preoperative serum ALT and TBIL were （141.3 ＋ 77.8） u/L and （21.3 -＋ 7.1） tLmol/L respectively. Five days after HAE the serum ALT and TBIL were （170.1 ＋ 98.6） u/L and （24.0 ＋ 9.1） ~mol/L respectively. The differences were not significant （P 〉 0.05）. The survival rates at one, 3, 6 and 12 months after HAE were 92%（23/25）, 84%（21/ 25）, 72% （18/25） and 48% （12/25） respectively. Conclusion For the treatment of massive bleeding due to ruptured primary liver cancer, HAE with Embosphere microspheres and Lipiodol is very effective and less invasive, and it is very helpful for the subsequent therapies. （J Intervent Radiol, 2014, 23： 156-158）
出处
《介入放射学杂志》
CSCD
北大核心
2014年第2期156-158,共3页
Journal of Interventional Radiology
基金
浙江省瑞安市科技局(201102035)
关键词
肝癌
出血
动脉栓塞
微球
hepatic cancer
bleeding
arterial embolization
microsphere
