转移性肝癌皮下埋植式动注化疗的经皮动注导管留置技术的探讨

Clinical Study of Transcatheter Arterial Chemoembolization in Treating Osteosarcoma

目的：观察侧孔注入式动注导管远端固定留置法预防肝动脉闭塞和消化道溃疡的效果，比较分析这种新的动注导管留置方法与传统的动注导管留置法及开腹直视下导管留置法的差异以及该方法尚存的问题。材料与方法：经左侧锁骨下动脉途径采用侧孔注入式动注导管远端固定留置法施行成功的１０４例转移性肝癌患者，留置术后随访期间１～９６周。结果：随访中确认肝动脉闭塞５例，发生率约５％，留置术后１周，经留置导管的核素９９ｍＴｃＭＡＡ扫描检查，７例消化道区域的核素聚集被显示，动注化疗过程随访中，经内窥镜检查确认胃溃疡３例，发生率约３％。结论：侧孔注入式动注导管远端固定留置法能明显降低肝动脉闭塞及消化道溃疡的发生率，是一种有效的预防和减少肝动脉闭塞及消化道合并症的方法。

Objective: To evaluate the effectiveness of transcatheter arterial chemoembolization (TAE) in the treating of osteosarcoma, and to observe the pathological changes produced by TAE.Materials and Methods:Surgical removal of pathologically proved osteosarcoma was performed in 32 patients having received TAE. The clinical symptoms, laboratory data and pathological findings before and after the surgery were recorded, and the results were compared with the control group of 11 cases receiving systemic chemotherapy.Results:Both the clinical improvement and the tumor necrosis extent in patients having received TAE were more significant than that in patients of control group.Conclusion: TAE should be considered as a therapeutic procedure of first choice in treating osteosarcoma.