原发性肝癌伴肝动静脉瘘的介入治疗(附36例报告)

Interventional therapy of hepatocellular carcinoma complicated by arteriovenous shunting (report of 36 cases)

目的回顾性研究以无水酒精为主的不同栓塞模式治疗肝癌合并肝动-静脉瘘的综合介入处理方法,探讨临床疗效,以期提高患者的生存质量和生存期。方法回顾南京军区南京总医院2009年3月～8月间收治的36例肝癌合并动静脉瘘病人,分析其临床资料。结果36例造影均在动脉期见门静脉或肝静脉提前显影。30例用无水酒精或辅以明胶海绵成功闭塞瘘病行TACE。结论超选择性无水酒精或辅以明胶海绵瘘口栓塞术对原发性肝癌合并动静脉瘘的治疗是一种安全、有效、合并症少的治疗方法。能为肿瘤的碘化油栓塞提供良好的治疗环境。

Objective To retrospectively study the effect of various interventional embolizing procedures for hepatoceUular carcinoma compli- cated by arteriovenous shunting and to discuss which procedures were more effective. Methods The clinical data including results of therapy of 36 hepatocellular carcinoma patients admitted between May 2009and August were retrospectively re,）iewed .Result On angiography, hepatic portal vein or hepatic vein were found in all 36 cases at arterial phase. 30 cases were successfully performed on embolization with ethanol or gelfoam. Conclusion Superselective embolization with ethanol or gelfoam is safe, effective and of little complications to the therapy of hepatocellular carcinoma complicated by arteriovenous shunting, and it can afford good therapeutic circumstances for embolization with lipoidol at the tumor.