暂时阻断肝静脉行肝动脉碘油栓塞的研究

Temporary Hepatic Venous Occlusion on Hepatic Arterial Embolization with Lipiodol

目的 研究肝静脉暂时阻断对肝动脉栓塞效果的影响。方法 2 0只SD大白鼠按照四种不同剂量的碘油 优维显混合物随机分为四组。暂时阻断 ( 10min)鼠肝静脉汇合处右侧部分行肝动脉碘油 优维显混合物栓塞 ,并于栓塞后取鼠肝标本。肝静脉阻断和非阻断区肝组织内碘油 优维显混合物的组织学检查采用苏丹Ⅲ染色。比较肝静脉阻断区和肝静脉非阻断区肝组织内碘油分布情况。结果 暂时阻断肝静脉与未阻断肝静脉区肝组织内的碘油分布有所不同 ,前者较后者肝区肝小叶内碘油沉积多 ,且门静脉属支末梢内亦有碘油沉积。结论 暂时阻断部分肝静脉行肝动脉栓塞 ,可增加碘油的栓塞作用 ,同时达到对肝动脉和门静脉的双重栓塞 ,此法有可能提高肝癌的化疗栓塞效果。

Objective To study the effect of temporary hepatic venous occlusion on hepatic arterial lipiodol-embolization.Methods Twenty SD rats were separated randomly into four groups with different doses of lipiodol-Ultravist mixture.A lipiodol-Ultravist mixture was injected into proper hepatic artery in rats during clamping the right side of the hepatic venous confluence about 10 minutes.The specimen of hepatic tissues with and without hepatic venous occlusion were obtained respectively after hepatic arterial embolization.The distribution of lipiodol-Ultravist mixture in hepatic tissues was analyzed by histological examination with Sudan Ⅲ.The extent of the distribution of lipiodol-Ultravist mixture in hepatic tissues with hepatic venous occlusion was compared with that without hepatic venous occlusion.Results Lipiodol-Ultravist mixture was more widely distributed in the lobules with hepatic venous occlusion than that in the lobules without hepatic venous occlusion.There were more deposition of Lipiodol-Ultravist mixture in the end branches of portal vein with hepatic venous occlusion.Conclusion Transcatheter arterial chemo-embolization during temporary hepatic venous occlusion may enhance the role of lipiodol and get the effect of double embolization both hepatic artery and portal vein.It could be useful in the treatment of hepatiocellular carcinoma.