经皮选择性肝脏隔离灌注化疗方法学研究

Methodological study on percutaneous selective ioslated hepatic perfusion chemotherapy

目的 探讨经皮选择性隔离肝脏灌注化疗的可行性及隔离效果。方法 将 12只猪随机分为两组 :HAI组 6只 ,进行常规经肝动脉灌注化疗 ;PSIHP组 6只 ,利用介入放射学方法进行经皮选择性隔离肝脏灌注化疗结合血液灌流。化疗药物选用 5 -FU ,分别检测肝静脉及外周血液中的血药浓度。结果 HAI组肝静脉血 (过滤前 )和外周静脉血浓度峰值分别为 (4 15 3 4± 4 30 2 ) ,(16 76 1± 2 2 6 9)mg/L ;PSIHP组分别为 (5 2 19 7± 5 30 2 ) ,(6 5 7± 6 4 )mg/L。两组差异有显著性 (P <0 0 1)。PSIHP组过滤后肝静脉血血药浓度峰值为 (4 0 8 7± 4 7 8)mg/L ,碳肾率过滤达到 (78 2± 7 4 ) %。结论 PSIHP是一种简单有效的肝脏隔离灌注化疗技术 ,与常规经肝动脉灌注化疗相比 ,不仅可以增加局部血药浓度 ,更可以降低外周血血药浓度 。

Objective To investigate the feasibility and the effect of percutaneous selective isolated hepatic perfusion chemotherapy(PSIHP). Methods Six pigs underwent the procedure of routine transhepatic arterial infusion(HAI) and the other 6 underwent PSIHP. 5-FU was used in our study. The plasma concentraiton of 5-FU in hepatic vein (before filtrating) and systemic vein was measured in both groups. Results The peak level of adriamycin concentration in hepatic vein (before filtrating) and systemic in HAI was ( 4?153 4±430 2) mg/L and ( 1?676 1±226 9) mg/L respectiely. In PSIHP, the peak level were( 5?219 7±530 2) mg/L and (65 7±6 4) mg/L. There were significant differences between HAI and PSIHP( P <0 01). Conclusion PSIHP is a simple and feasible method for isolated hepaitic perfusion. Compared with HAI, using the technology of PSIHP, the concentration of chemotherapeutic agents increases in regional liver and significantly decreases in systemic circulation.