摘要
目的探讨原发性肝癌合并肝动静脉瘘(arteriovenous shunting,AVS)的介入栓塞治疗策略及疗效。资料与方法 39例原发性肝癌合并AVS患者,超选择插管造影明确AVS的类型、分流量及肿瘤血供后,按不同方式进行堵瘘及肿瘤化疗栓塞治疗。术后观察临床症状改善及肿瘤变化,随访生存期3～12个月。结果 37例完成化疗栓塞,2例仅行化疗灌注。首次治疗瘘口消失或分流减少35例,CT显示碘油较好沉积或肿瘤稳定缩小34例。术后大部分顽固性腹腔积液、腹泻及上消化道出血等症状控制或改善,无肺栓塞、肝功能衰竭等并发症。3个月、6个月、12个月生存率分别为94.9%、87.2%、41.0%。结论精细的超选择插管造影及瘘口封堵有助于原发性肝癌合并AVS的大部分栓塞,改善患者临床症状并延长生存时间。
Objective To explore the strategy and cilnical effect of interventional chemoembolization in treatment of primary hepatocelluar carcinoma（HCC） combined with different types of arteriovenous shunting（AVS）.Materials and Methods Thirty nine patients with HCC combined with AVS were collected in the study.The details of shunting and tumor feeding vessel were evaluated by superselective angiography and both blocking up fistula and chemoembolization treatment were carried out.The clinical symptom and tumor size were observed for 3-12 months after surgery.Results Thirty seven cases performed chemoembolization and 2 cases performed intraarterial infusion.Shunting orifice sealed or ameliorated in 35 cases（89.7%）after first treatment.Lipiodol deposit and tumor shrank were observed on CT images in 34 cases.Symptoms such as obstinate ascites,diarrhea and upper gastrointestinal hemorrhage were alleviated.No serious complications such as pulmonary embolism or liver function failure occurred.Survival rate was 94.9%,87.2%,41% at 3,6 and 12 months after surgery,respectively.Conclusion Carefully superselective angiogram and appropriate blocking up fistula are beneficial to embolize HCC with AVS,which can alleviat symptoms and prolong survival time.
出处
《临床放射学杂志》
CSCD
北大核心
2011年第1期82-85,共4页
Journal of Clinical Radiology
关键词
动静脉瘘
原发性肝癌
栓塞
介入性
Arteriovenous shunting Primary hepatocellular carcinoma Embolization
interventional
