平阳霉素+碘油乳剂栓塞治疗肝海绵状血管瘤的疗效观察

The therapeutic effect of Pingyangmycin lipiodol emulsion embolization for hepatic cavernous hemangioma

目的 评价平阳霉素碘油乳剂栓塞肝海绵状血管瘤的临床疗效。方法 对18例患者采用Seldinger技术股动脉插管,将导管超选择至肿瘤供血动脉,缓慢注入利多卡因5-10 m1及平阳霉素碘油乳剂5-20 ml。栓塞前常规肌内注射杜冷丁50-100 mg;病变巨大、多支血供、病人年龄>60岁者,分次介入治疗。术后3-48个月CT、B超随访观察栓塞前后肿瘤直径大小变化、临床症状缓解情况及并发症。结果 18例肝海绵状血管瘤均见平阳霉素碘油完全充填。病灶完全消失9例,缩小50％以上7例,病灶缩小25％-50％2例。其中6例血管造影复查见病灶血管完全消失,载瘤动脉闭塞。临床症状好转率89％,无严重并发症。结论 平阳霉素碘油乳剂动脉栓塞肝海绵状血管瘤疗效良好,微创、安全、副作用少,可作为首选的治疗方法。

Objective To evaluate the therapeutic effect of Pingyangmycin lipiodol emulsion (PLE) embolization for cavernous hemangioma of liver (CHL). Methods Seldinger technique was adopted and the catheter was super-selectively sent into the supplying artery of tumors in 18 CHL patients, 5-10 ml of Lidocaine and 5-20 ml of PLE were slowly injected. Before the embolization, 50-100 mg of pethidine was routinely injected. The embolization was conducted in several times in patients with large tumors, with multiple supplying arteries, and whose age was above 60 years. During the 3-48 months'follow-up after the operation,the change of the tumor diameter before and after the embolization was compared by using CT and ultrasound. The clinical symptomatic relief and the complications were also observed. Results The CHL of all the 18 cases were filled up by PLE. The foci were completely vanished in 9 cases, reduced by over 50% in 7 cases,and reduced by 25%-50% in 2 cases,respectively. The follow-up angiographic examination was performed in six cases, the tumor staining was completely vanished and the tumor-supplying artery was closed up. The improving rate of the clinical symtoms reached 89% . There were no serious complications. Conclusion The PLE embolization in hepatic cavernous hemangioma proves to be reliable, safe, minimally invasive, and with little side effect. This therapy, therefore, can be the first method of choice in treating the cavernous hemangioma of the liver.