经导管动脉化疗与栓塞治疗肾恶性肿瘤的临床与病理观察

Clinical and pathologic observation on malignant tumors of the kidney after chemoembolization

目的：观察动脉化疗与栓塞治疗肾恶性肿瘤的临床与组织学疗效。方法：１９９０～１９９５年间行化疗栓塞加手术治疗（栓塞组）肾恶性肿瘤２２例，单纯手术切除（对照组）肾肿瘤２２例。对两组的手术时间、术中出血量以及术后组织学改变进行统计学分析处理。结果：（１）平均手术时间栓塞组为（９２．７±２２．９）ｍｉｎ，对照组为（１３４．５±３３．８）ｍｉｎ，（ｔ＝４．８，Ｐ＜０．００１）；术中出血量：栓塞组为（２２３±８４）ｍＬ，对照组为（４４３±１２４）ｍＬ，（ｔ＝６．９，Ｐ＜０．００１）。（２）栓塞组的组织有效率为８１．８％，与对照组（９．１％）比较差异有显著性（χ２＝１８．８，Ｐ＜０．０１）。结论：术前化疗栓塞对减少肾恶性肿瘤手术时间、术中出血量、提高组织学有效率及手术切除率均有显著的临床意义，也是中晚期肾恶性肿瘤有效的姑息治疗手段。

Objective:To observe clinical and pathologic effects of chemoembolization on malignant tumor of the kidney.Methods:44 patients with renal malignancies were divided into two groups:Group Ⅰ( n =22)received chemoembolization before surgical operation,and Group Ⅱ( n =22) received only surgical operation.The needed operation time,bleeding output during operation and postoperative histological changes were compared between the two groups.Results:(1)The average operation time and bleeding output were significantly less in Group Ⅰ than those in Group Ⅱ (92.7±22.9)min and (223±84)mL vs(134.5±33.8)min and(443±124)mL, P< 0.01 and P< 0.001 respectively);(2)the histological effective rate was markedly higher in Group Ⅰ as compared with Group Ⅱ(81.8% vs 9.1%, P< 0.01).Conclusion:Chemoemobolization before surgical operation for renal malignancies can effectively lessen the needed surgical time,bleeding output during operation and improve postoperative histology,and it is an effective method in treatment of renal malignancies at middle or advanced stage.