巨大肝海绵状血管瘤介入治疗的疗效评价

Evaluation of interventional therapy for huge hepatic mangioma

目的:评价平阳霉素碘化油乳剂经选择性肝动脉栓塞治疗巨大肝海绵状血管瘤的临床应用和疗效。方法:对32例有症状的巨大肝海绵状血管瘤患者采用Seldinger技术,经皮股动脉穿刺行肝动脉插管注入平阳霉素碘化油乳剂栓塞硬化肝血管瘤体,并用明胶海绵颗粒栓塞瘤体供血动脉。栓塞术后3、6、12和18个月的随访观察肿瘤大小变化、临床症状缓解和并发症发生情况。结果:栓塞治疗后肿瘤进行性缩小,术后第3、6、12、18个月复查,肿瘤平均缩小程度分别为29.6%、43.7%、56.3%、64.8%;其中3例肝血管瘤分别于第12个月和第18个月复查时CT或MRI提示消失;所有患者临床症状明显减轻或消失,无严重并发症发生。结论:介入栓塞治疗巨大肝海绵状血管瘤安全有效、并发症少,具有重要的临床应用价值。

Objective：To evaluate the clinical value and therapeutic effect of selective hepatic artery embolization with Pingyangmycin-lipiodol emulsion （PLE） in treatment for huge hepatic hemangioma （HHE）. Methods：32 patients with huge HHE were treated with PLE by selective hepatic artery embolization and sclerosis,and the supplying arteris of the tumors were embolized by gelfoam particles via femoral artery with Seldinger technique. All patients were followed-up for 3,6,12,18 months after the embolotherapy. The size of tumors was measured and compared before and after the embolotherapy,the clinical symptoms and complications were observed. Results：After the embolotherapy,the size of tumors was decreased evidently. By the end of the the third,the sixth,the twelfth and the eighteenth month,there was an average shrinkage of 29.6%,43.7%,56.3% and 64.8% in the size of tumors retrospectively. After the embolotherapy,and CT or MRI indicated the HHE disappeared entirely in 3 cases at the end of the twelfth and the eighteenth month. The clinical symptoms were alleviated or recovered completely. No severe complications occurred. Conclusion：It is suggested that selective hepatic artery embolization with Pingyangmycin-lipiodol emulsion is safe and effective with fewer complications on huge HHE.