肝癌介入治疗肺部合并症的X线表现

X－ray manifestation of pulmonary complication in interventional therapy of hepatic carcinoma

目的探索肝癌介入治疗 (TACE)引起肺部合并症的 X线表现。方法 5例患者均是插管至肝固有动脉注入表阿霉素、顺铂、丝裂霉素、碘油与丝裂霉素混合物。患者都于术中出现胸闷，咳嗽等症状，术后摄胸部、腹部平片。结果 1例双肺满布蜂窝状阴影。 2例双肺弥漫网格状、小点状、小结节状病灶，少许蜂窝状病灶。 2例肺野散在小点状、结节状病灶。 1个月后复查： 5例患者肺部可见点状高密度，条索状影。结论在肝癌 TACE治疗过程中，部分药物可经由肝动脉－肝静脉瘘途径直接达到肺部，引起急性的类似于间质性肺炎的肺损伤。

： Objective To investigate x－ ray manifestation of pulmonary complication of the hepatocellular carcinoma patients with interventional therapy.Methods 5 hepatocellular carcimona patients were intubated to hepatic proper artery and injected epirubicin、 cisplatine、 mitomycin and conbination of iodipin and mitomycin.All patients had symptoms of chest oppression and cough during the injection.so chest and abdominal x－ ray were taken after operation.Resu1ts One case had honeycomb－ like shadow all over the lung.Two had diffuse reticular and punctiform nodular shadow and few honeycomb－ like shadow. The others punctiform shadow were few. All patients had some hyperdense punctiation and stripes in lung one month after operation.Conclussion The results show that during the hepatocellular caracimoa TACE therapy,Chemotherapy drugs and embolus can direct reach lung via hepatic artery－ hepatic vein fistula and cause acute pulmonary injury that are similar to interstitial pneumonia.