经皮经股动脉植入药盒在晚期恶性肿瘤治疗中的应用

Percutaneously Transfemoral Artery Implantation of DDS for Arterial Infusion Therapy of Advanced Malignant Neoplasms

目的：探讨经股动脉植入药盒的操作技术，论证此种植入方法的可行性。材料与方法：５２例晚期恶性肿瘤患者采取经皮经股动脉植入药盒治疗，其中肝癌４４例，肺癌３例，盆腔肿瘤３例，肾癌和十二指肠壶腹部癌各１例，依据肿瘤供血特点，在ＤＳＡ路标及透视监控下，施行药盒植入术。药盒导管端植入靶动脉内，药盒体埋置在穿刺点下方皮下（大腿内侧），术后两周１次冲洗药盒。结果：随访３～１８个月，并发症为：导管移位５例，靶动脉闭塞１例，导管阻塞１例，并发症发生率为１３．５％。植入药盒侧股动脉彩色血流分析及血管造影未见异常。结论：经皮经股动脉植入药盒是安全可行的，操作简便易行，易于超选插管，可由放射科医生单独实施，并发症少。

Objective: To study percutaneously transfemoral implantation of drug delivery system (DDS). Materials and Methods:52 patients with advanced malignant neoplasm were treated by intra arterial infusion therapy using DDS implanted by percutaneously transfemoral artery (44 cases liver cancer, 3 cases primary bronchogenic carcinoma of lung, 3 cases pelvic noeplasm, 1 case renal carcinoma, 1 case duodenal carcinoma). We perfomed implantation of DDS under DSA and fluoroscopy according to blood supply artery of tumor. The implantable catheter tip was positioned in target artery. Body of DDS was subcutaneously implanted below puncture point of femoral artery. DDS is flushed with heparin or saline salution once every two weeks after implantation.Results:Complications occurred as follows: Dislocation of the tip of cathter in 5 cases, target arteries occlusion in 1 case and catheter occlusion in 1 case. Femoral arteries implanted display normal findings at US and DSA.Conclusion: Percutaneously transfemoral artery implantation of DDS is safe and feasible. Implantation is easily perfomed by radiology doctor alone, and complication are greatly reduced.