原发性肝癌寄生性供血与介入治疗

Parasitic blood supply of primary hepatic carcinoma and the interventional therapy

目的探讨原发性肝癌寄生性供血情况,提高TACE治疗肝癌的疗效。方法本组30例原发性肝癌患者行常规腹腔动脉造影及寄生血管探查,并对其行超选择插管及化疗栓塞治疗(TACE)。结果30例患者共见32条肝外寄生血管,其中膈下动脉(10/32),肠系膜上动脉(8/32),胃十二指肠动脉及胃网膜动脉(6/32),胃左动脉(4/32)占多数。5条寄生性血管因细小迂曲未能成功行超选择插管只给予化疗灌注治疗,其余27条寄生血管均行超选择插管和化疗栓塞治疗,一月后复查,CT示肿瘤缩小,碘油沉积致密完全。结论原发性肝癌寄生性供血较为常见和多变,认识原发性肝癌寄生性供血的特点及规律并进行双重血管栓塞,能进一步提高原发性肝癌TACE治疗效果。

Objective To investigate the parasitic blood supply of primary hepatic carcinoma and the efficacy of transcatheter arterial chemoembolization treatment （TACE）. Methods 30 cases of primary hepatic carcinoma were performed routine celiac artery angiography and conventional angiography parasitic exploration, and subjected to superselective catheterization and transcatheter arterial chemoembolization （TACE）. Results In a total of 30 cases of patients, 32 extrahepatic parasitic blood vessels were found, including inferior phrenic artery （10/32）, superior mesenteric artery （8 / 32）, gastroduodenal artery and gastroepiploic artery （6 / 32）, left gastric artery （4 / 32）. 27 parasitic blood vessels were subjected to superselective catheterization combinding with routine TACE. The remaining 5 parasitic small tortuous blood vessels did not succeed in superselective catheterization, routine TACE only. A month later review, CT showed tumor shinkage ,dense lipiodol deposites completely. Conclusion Parasitic blood supply of primary liver cancer are more common and variable. Recognizing the parasitic blood supply characteristics of primary hepatic carcinoma and applying combination thearapy could further improve the efficacy of TACE treatment.