短期反复行GS-TAE治疗伴动门脉瘘肝细胞癌的临床观察

Hepatocellular carcinoma with A-P shunt treated by repeated GS-TAE after short interval

目的:探讨短期反复行明胶海绵肝动脉栓塞术对伴动门脉瘘的肝细胞癌的疗效。资料与方法:经CT、MRI诊断肝细胞癌,血管造影确认均有动门脉瘘形成的患者14例,其中男13例,女1例,将明胶海绵碎块与抗癌药混合并行肝动脉栓塞术,明胶海绵颗粒直径均选择在0.5～1mm之间,栓塞次数3～5次,栓塞间隔3～5周。结果:12例治疗后癌灶范围缩小(85.7%),全部14例A-Pshunt消失,患者生存时间4～26个月。9例同时伴有门脉癌栓,治疗后8例门脉癌栓缩小或回缩(88.9%),其中1例门脉癌栓甚至完全消失。结论:短间隔反复明胶海绵肝动脉栓塞术是治疗伴动门脉瘘的肝细胞癌的有效方法。

Objective: To estimate the curative effect of short interval repeated GS-TAE in the treatment of hepatocellular carcinoma with A-P shunt. Materials and Methods: Fourteen cases(13 men, 1 woman) were diagnosed as HCC by CT, MRI. All of them were proved to have HCC with A-P shunt by angiography. Gelatin sponge was mixed with anticancer medicine as embolus to embolize the artery 3～5 times. The size of gelatin sponge was 0.5～1mm. GS-TAE was performed with the interval of 3 to 5 weeks. Result: The tumor size became smaller in 12 cases(12-14, 85.7%) and A-P shunt disappeared in all of the 14 cases. The patients were still surviving for 4 to 26 months. Porto-thrombosis was detected in 9 cases, and it was found to become smaller in 8 cases. In 1 case, porto-thrombosis was not even observed. Conclusion: Short interval repeated GS-TAE is an effective method in the treatment of hepatocellular carcinoma with A-P shunt.