经导管肝动脉栓塞治疗肝海绵状血管瘤

Treating cavernous hemangioma of the liver by means of transcatheter hepatic arterial embolization

目的:探讨肝海绵状血管瘤 (CHL)的最佳栓塞治疗方案 ,并比较不同栓塞方法的疗效。 方法 :4 1例CHL 患者分为 3组 :单纯超液态碘化油栓塞组 (L P组 ) 11例 ,1∶ 1碘化油与鱼肝油酸钠混合栓塞组 (L P+V组 ) 18例 ,1∶ 1碘化油与鱼肝油酸钠再加明胶海绵 (颗粒或条 )综合栓塞组 (L P+V+G组 ) 12例。对栓塞治疗前后瘤体大小及染色面积的改变进行分析。 结果:3种不同的治疗方法分别使瘤体最大径由 (5 .97± 1.4 7) cm、(8.4 2± 2 .90 )cm、(7.36± 2 .84 ) cm缩小至 (4.5 0± 1.77) cm、(5 .88± 2 .5 0 ) cm、(4.4 2± 2 .14 ) cm,综合栓塞组优于单纯栓塞组(P <0 .0 5 )。瘤体染色面积的改变 ,综合栓塞组优于 L P与 L P+V组 (P均 <0 .0 5 )。 结论 :(1)经导管肝动脉栓塞治疗肝海绵状血管瘤 ,方法简单、安全有效 ;(2 )

Objective: To investigate the best embolic schema and the efficiency of three different embolic methods. Methods: Among the 41 cases, 11 cases were embolized using only lipiodol (LP group), 18 cases were treated using lipiodol and varicocid with a proportion of 1∶1 (LP+V group), and 12 cases were embolized using lipiodol and varicocid and gelfoam (LP+V+G group). Tumor sizes and stain areas before and after treatment were measured by CT and DSA. Statistical analysis was done using SAS. Results: Three different methods showed that tumor diameter(cm) decreased from 5.97±1.47, 8.42±2.90, 7.36±2.84 to 4.50±1.77, 5.88±2.50, 4.42±2.14 respectively. Two of the three groups were compared, It indicated that comprehensive embolization was better than the other two methods. The changing of tumor's stain area was measured by DSA also proved the same results. Conclusion: (1)Transcatheter hepatic arterial embolization is easy and efficient. It can be considered as the first therapeutic option in these cases; (2)The keys to success are the super selection of feeding arteries and the comprehensive embolization.