肝癌患者经导管肝动脉化学栓塞治疗后的胃十二指肠粘膜病变

Gastroduodenal Mucosa Damage Caused by Transcatheter Arterial Chemo-embolization in Patients with Hepatocellular Carcinoma

本文对26次(21例肝癌患者)经导管肝动脉化学栓塞治疗(TACE),观察了胃十二指肠粘膜损害的发生情况和内镜下表现.26次中有10次出现新的胃十二指肠粘膜病变(38.5%).病变位于胃体至十二指肠降部,主要表现为散在性或弥漫性充血斑,散在性出血点,单发或多发的糜烂面及浅溃疡.发生的原因主要是栓塞物质进入胃十二指肠动脉和胃右动脉,造成粘膜缺血的结果.为避免此种并发症,应尽量超选插管和缓慢灌注栓塞物质.

We investigated the incidence and endoscopic features of gastroduodenal damages as a result of tran-scatheter arterial chemo-embo]ization(TACE) in 26 catheterizations in 21 patients with hepatocellular carcinoma. The incidence of gastroduodenal lesions after TACE was noticed in 10/26(38. 5%). The lesions caused were located form the gastric body to the second portion of the duodenum and were manifested as discrete or diffuse erythemas,discrete hemorrhagic spots, single or multiple erosions and shallow ulcers. The main cause of the lesions can be alluded to ischemia resulted from entrance of embolizing materials into the gastroduodenal artery and/or right gastric artery. In order to avoid such complications, it is important to insert catheter precisely and to infuse embolizing materials slowly.