无水乙醇-碘油栓塞治疗肝脏海绵状血管瘤

Transcatheter arterial embolization with the mixture of ethanol and lipiodol for the treatment of hepatic cavernous hemangiomas

目的探讨经微导管无水乙醇-碘油动脉栓塞治疗肝脏海绵状血管瘤的疗效和安全性。方法回顾性分析25例肝脏海绵状血管瘤,以无水乙醇-碘油乳剂(乙醇-碘油比例为2∶1)8～25ml行超选择肝动脉栓塞。观察术后肿瘤大小、肝功能及临床症状。结果所有病例均成功实施了栓塞治疗,其中最大病灶位于肝右叶15例、肝左叶10例,肿瘤最大径6.5～15.3cm,平均(8.2±2.0)cm,栓塞后6、12个月观察见肿瘤明显缩小,分别为(5.3±1.6)cm和(2.8±1.2)cm(P<0.01),患者临床症状缓解、术后除轻度腹痛、发热,转氨酶短时间轻度升高并于2周后恢复外,未发生其他严重并发症。结论无水乙醇-碘油栓塞是肝脏血管瘤治疗的一种安全有效方法 。

Objective To evaluate the therapeutic effect and safety of trans-microcatheter arterial embolization with the mixture of ethanol and lipiodol in treating hepatic cavernous hemangiomas. Methods Trans-microcatheter arterial embolization with the mixture of ethanol and lipiodol was performed in 25 patients with hepatic cavernous hemangiomas. The ratio of ethanol to lipiodol was 2 to 1, and the dose of the mixture used in one session was 8-25 ml. After the procedure necessary supportive measures were employed. All the patients were followed up for 12 months. The postoperative observations included the tumor＇s size, liver function, complications and the clinical manifestations. The clinical data were statistically analyzed. Results Technical successes was achieved in all patients. Of the 25 patients, the largest lesion of the hemangiomas was located at the right lobe in 13, at the left lobe in ten. Before the treatment the maximum diameter of the tumor was （6.5-15.3） cm with a mean diameter of （8.2 ± 2.0） cm. After the treatment the maximum diameter of the tumor significantly decreased to （5.3 ± 1.6） cm in 6 months （t = 5.513, P〈 0.01）, and to （2.8 ± 1.2） cm in 12 months （t = 25.412, P〈 0.01）. Transient impairment of liver function was observed in 20 cases after embolization, in 19 of which the liver function returned to normal in 2 weeks. The clinical symptoms were significantly relieved in all 25 symptomatic patients. Conclusion Trans-micorcatheter arterial embolization with the mixture of ethanol and lipiodol is a safe and effective treatment for hepatic cavernous hemangiomas.