肝海绵状血管瘤的介入治疗

Interventional therapy for hepatic cavernous hemangioma

目的评价使用平阳霉素碘化油乳剂经肝动脉栓塞治疗肝海绵状血管瘤的临床疗效。方法50例肝血管瘤患者,其中男性21例,女性29例,年龄23～70岁,平均年龄49岁。血管瘤位于肝左叶11例,肝右叶32例,同时累及肝两叶者7例;病变单发者30例,多发者20例。有上腹隐痛、腹胀、贫血及腹部包块等症状者22例,无症状者28例。全部病例经B超、CT、MRI和/或肝动脉造影确诊。采用DSA设备,以Seldinger技术经股动脉穿刺插管,行选择性肝动脉、肠系膜上动脉造影。其中10例为2次栓塞,40例行1次栓塞。通过导管超选择插管至肝血管瘤的供血动脉,使用平阳霉素碘化油乳剂经肝动脉进行栓塞治疗。结果所有病例均成功实施了栓塞治疗,治疗后患者症状缓解,瘤体缩小,无严重并发症,生活质量明显提高。结论使用平阳霉素碘化油乳剂经肝动脉栓塞治疗肝海绵状血管瘤疗效肯定,安全性好。

Objective To study the therapeutic effect of pingyangmycin iodine emulsion for hepatic artery embolization in hepatic cavernous hemangioma. Methods A total of 50 patients （male 21 and female 29,aged 23 - 70 years,mean age 49 years） with liver angioma were enrolled in this study. In these patients the angiomas of 11 patients were located in left liver lobule,32 in right lobule and 7 in both lobules;consisting single angioma（n = 30） and multiple angioma（n = 20）. The syptoms in 22 patients were upper-abdomen pain,slightly swelling,anaemia and abdominal mass,while the other 28 patients were asymptomatic angioma. The angioma in all patients had been identified by ultrasonic-B, CT, MRI and liver artery angiography. The femoral artery puncture and catheter introducing with Seldinger＇s approach were applied,then selective liver and supermesentery angiographic embolisms were performed twice in 10 patients and 1 time in 40 patients. Fifty patients with hepatic cavernous hemangioma were treated with pingyangmycin iodine emulsion through hepatic artery,and selectively pluged the conduit in the artery of hepatic cavernous hemangioma for embolizing. Results All patients were performed successfully. After interventional treating,the clinical symptoms were significantly released,and tumor size decreased in all patients. Severe complications were not found. The live quality of patients were improved. Conclusion It is demonstrated that the hepatic artery embolization with pingyangmycin iodine emulsion is an effective and safe approach in treatment of hepatic cavernous hemangioma.