平阳霉素碘油乳剂动脉栓塞治疗肝血管瘤的中远期疗效评价

The middle-long term effect of TAE with pingyangmycin-lipiodol emulsion for hepatic hemangioma

目的评价平阳霉素碘油乳剂(PLE)经动脉栓塞治疗肝血管瘤的中远期疗效。方法 2000年4月至2010年9月在沈阳中国医科大学第一附属医院116例肝血管瘤患者接受经动脉PLE栓塞治疗,术后进行定期随访。参照WHO实体瘤疗效评价通用标准,根据肿瘤的缩小率评价其临床疗效,同时观察临床症状的改善和并发症情况。结果对116例患者的139个病灶成功实施了栓塞治疗。随访6个月～10年,87例术前有临床症状的患者79例症状完全消失,6例缓解,2例无变化,有效率97.7%。术后复查病灶有不同程度的缩小,术后6个月～1年,1～3年,3～5年,5～10年的有效率分别为84.2%、85.4%、88.1%、96.4%。长期随访的28个病灶术后6个月～1年、1～3年、3～5年、5～10年瘤体的最大截面积分别为(30.54±23.98)cm2,(24.89±19.48)cm2,(20.73±17.78)cm2,(17.30±15.21)cm2,分别与术前[89.44±67.93)cm2]相比,差异均有统计学意义(P<0.05)。所有病例均未出现严重的并发症。结论PLE经动脉栓塞治疗安全、有效、适应证广、并发症少,是治疗肝血管瘤的理想方法。

Objective To evaluate the middle-long term effect of transcatheter arterial embolization（TAE） with pingyangmycin-lipiodol emulsion（PLE） in the treatment of hepatic hemangioma.Methods Collected 116 hepatic hemangioma cases underwent interventional treatment with PLE in our hospital from April 2000 to September 2010.According to WHO solid tumors reference standard,evaluate clinical efficacy by the reduction rate of tumor;the changes of the clinical symptoms and complications were all recorded in the follow-up data.Results 139 lesions of 116 cases were treated successfully.Follow-up 6 months to 10 years,the clinical symptoms disappeared in 79 cases,relieved in 6 cases and no change in 2 cases,effective rate is 97.7%.The size of the lesions reduced in different degrees.The effective rate of 6 months to 1 year,1 to 3 years,3 to 5 years and 5 to 10 years were 84.2%,85.4%,88.1% and 96.4% respectively.The largest cross-sectional areas of long-term follow-up 28 lesions were（30.54 ± 23.98）cm2,（24.89 ± 19.48）cm2,（20.73 ± 17.78）cm2,（17.30 ± 15.21）cm2 respectively,compared with preoperative [（89.44 ± 67.93）cm2] respectively with a significant difference（P 0.05）.There were no serious complications in all cases.Conclusion TAE with PLE in hepatic hemangioma proves to be effective,safe and little side-effects.It has broad indications and is an ideal method in the treatment of hepatic hemangioma.（J Intervent Radiol,2012,21： 31-34）