热碘油经微导管栓塞技术在肝癌介入治疗中的应用

Intratumoral embolization therapy through microcatheterization with hot ultra-fluid lipiodol for carcinoma of the liver

目的研究应用热碘化油经微导管栓塞技术在肝癌介入治疗中的临床价值。方法26例结节型肝癌(原发性23例,转移性3例)接受了78次微导管栓塞术治疗。均施行瘤内热碘油(65℃)栓塞术,其中,载瘤动脉保护性血栓栓塞术3次,瘤内动-静脉瘘无水酒精栓塞术3次。结果26例均获得瘤体内完全性、充填性栓塞。3例病人发生上腹部不适,2例经手术切除证实瘤体完全坏死。随访14-26个月,所有病人均存活,未发生严重并发症。结论采用热碘化油经微导管栓塞技术治疗肝癌可明显提高治疗效果;充分超选到位、逐支栓塞、脉冲挤压式充填法和灵活的微导管应用技术是栓塞成功的关键。

Objective To study the value of the intratumoral embolization therapy using the skills of microcatheterization with hot ultra - fluid lipiodol for carcinoma of the liver. Methods 26 cases of embolization therapy through microcatheter were performed in 26 patients who had single nodular hepatocellular carcinoma（23 patients）or liver metastasis（3 patients）. 78 times of the intratumoroal embolization therapy using hot lipiodol（65℃）were performed in 26 patients. The protective embolization with thrombus were done in 3 patients. 3 times of the fistula embolization using absolute alcohol was done in 3 patients with small intratumoral A - V fistula. Results The completely filled - full intratumoral embolization was obtained in all patients, although the negative timing on angiogram of celiac and superior mesenterie arteries occured in 3 patients. The complete necrosis was confirmed in 2 patients followed by carcinoma resection. Within the follow - up 14 months to 26 months（average 20 months）, 26 patients were all alive and there was no serious complication occurred. Conclusions The completely filled - full intratumoral embolization for carcinoma of the liver can be achieved by using the skills of microcatheterization therapy with hot ultra- fluide lipiodol.