肝血管瘤肝动脉栓塞的疗效评价

Evaluation of the efficacy of arterial embolization in treatment of liver hemangioma (LH)

目的评估经肝动脉途径超选择介入栓塞肝血管瘤的临床疗效。方法对采用经动脉介入治疗的42例肝血管瘤患者进行回顾性分析。全部病例采用Seldinger穿刺插管行超选择性肝动脉或肠系膜上动脉造影并行栓塞术。栓塞材料采用液化碘油+博来霉素+海藻酸钠微球。结果随访6～48个月。40例经1次治疗后,临床症状逐渐减轻至消失;2例经第二次治疗后,临床症状消失;12个月后行CT复查,部分患者病灶内仍有碘化油沉积,经CT加强扫描显示:10例肝血管瘤完全消失,30例肝血管瘤明显缩小,2例稳定,无一例出现严重的栓塞综合征。术后住院3～5d。结论经肝动脉途径超选择介入栓塞肝血管瘤临床疗效确切,手术创伤小,操作安全、简便,患者痛苦少、恢复快,住院时间短。

Objective To evaluate the efficacy of superselective arterial embolization in treatment of liver hemangioma. Methods Forty-two cases of liver hemangioma treated with superseleetive arterial embolization were reviewed. The femoral artery puncture and catheter introduction with Seldinger＇s approach were applied ,then superselective hepatic artery or superior mesentery artery angiography followed by embolism with mixture of lipiodol ＋ bleomycin ＋ sodium alginate microball was performed. Results The symptoms disappeared or were alleviated in 40 patients treated once, and in 2 patients treated twice. Twelve months later, the CT image showed still presence of lipiodol in the focus. The hemangiomas disappeared in 10 patients, the size of hemangioma reduced in 30 patients, stabilized in 2 eases and no serious embolization syndrome occurred. The patients stayed in hospital for 3-5 days after arterial embolization. Conclusion The treatment of liver hemangioma with superseleetive arterial embolization has definite clinical efficacy, and has the advantages of minimally invasive, safe, rapid recovery and inexpensive.