肝癌患者动脉化疗栓塞治疗后上消化道粘膜损害

Gastroduodenal Lesions After Transcatheter Arterial Chemo-Embolization in Patients with Hepatocellular Carcinoma

本文对17例肝癌患者行20次肝动脉化疗栓塞(TACE)后上消化道粘膜损害的发生率和内镜下特征进行初步探讨。TACE后有12例次出现新的上消化道粘膜损害或原病损加剧占60％,损害部位自食道至十二指肠降部,粘膜呈弥漫性或局灶性。粘膜损害呈不规则充血、水肿、糜烂和粘膜下出血灶。分析其损害原因可能与栓塞物质造成粘膜缺血、抗癌药物毒性作用和应激反应有关,鉴此,在行TACE术前建议应常规做胃镜检查。

We investigated the incidence and endoscopic features of gastroduodenal lesions which appeared after transcatheter arterial chemoembolization (TACE), performed 20 times in 17 patients with inoperative hepatoeellular carcinoma. The new development or exacerbation of the gastroduodenal lesions after TACE was evident in 12 of 20 (60%) The side of the lesions ranged from esophagus to the second portion of the duodenal, and the lesions that developed were multiple erosions and multiple hemorrhagic erosions. The development of these gastroduodenal lesions may be due to mucosal ischemia caused dy embolic materials, the toxic effect of infused antineoplastic drugs, or due to stress. In view of these events, upper gastrointestinal endoscopy should be used as a routine examination for patients undergoing TACE.