肝癌患者经肝动脉CO_2-DSA和常规碘-DSA诊断的对照研究

Comparative study on hepatic artery CO_2-DSA and conventional-DSA in patients with liver cancer after iodine

目的探讨肝癌患者经肝动脉CO2-DSA和常规碘-DSA诊断的临床效果及安全性,为临床上使用CO2-DSA技术对肝癌患者进一步明确诊断提供参考价值。方法将我院收治的282例肝癌患者依据检查方法分成观察组(150例)和对照组(132例),观察组采用经肝动脉CO2-DSA,对照组采用经肝动脉常规碘-DSA,比较两组门静脉显示情况、门脉癌栓显示率、动静脉瘘诊断、图像质量、不良反应发生率等指标的差异。结果观察组的图像质量为1级的有139例,明显高于对照组的98例,质量为3级的为3例,明显少于对照组的13例,两组图像质量3级分布上差异具有统计学意义(P<0.05);观察组门静脉显示得分(4.6±0.4),明显高于对照组的(3.8±0.7),观察组的血管轮廓显示得分(2.7±0.3),明显高于对照组的(2.1±0.6),观察组不良反应评分(1.2±0.4),明显低于对照组的(2.8±0.9),以上指标两组比较差异具有统计学意义(P<0.05);观察组的肝动脉门静脉瘘显示、肝动脉肝静脉瘘、门脉癌栓显示情况分别为63(42%)、35(23.33%)、25(16.67%)明显高于对照组的38(28.79%)、17(12.88%)、11(8.33%),两组以上各指标统计学检验差异均具有统计学意义(P<0.05)。结论采用经肝动脉CO2-DSA能够提高诊断图像的质量、提高诊断的准确率、降低不良反应的发生。

Objective To investigate the clinical efficacy and safety in patients with hepatocellular carcinoma after hepatic artery CO2-DSA and conventionaliodine-DSA ,for clinical use of CO2-DSA technology for the liver cancer patients for further diagnosis provides the reference value .Methods A total of 282 cases of hepatocellular carcinoma patients in our hospitaloncology and were divided into observation group （150 cases） and control group （132 cases） by transcatheter arterial CO2-DSA ,the control group using conventionaliodine-DSA via hepatic artery ,compared with two groups of portal vein tumor thrombus in the portal vein display ,display rate of fistula ,arteriovenous differences ,diag-nosis the image quality ,the adverse reaction rate index .Results To observe the image quality group for level 1 of the 139 cases ,98 cases were significantly higher than control group ,quality level 3 in 3 cases was less than 13 cases in the control group ,statistically significant 3 level two groups of image quality difference （P〈0 .05）;observation group （4 .6 ± 0 .4） portal vein was showed significantly higher scores in the control group （3 .8 ± 0 .7） ,observation group （2 .7 ± 0 .3） contour display scores were higher than those in the control group was （2 .1 ± 0 .6） ,the adverse reactions observed score was 1 .2 ± 0 .4 ,significantly lower than the control group （2 .8 ± 0 .9） ,with statistical significance of the a-bove index difference between the two groups （P〈0 .05） .For observation group ,the hepatic artery and portal vein fistula ,hepatic artery hepatic vein fistula ,portal vein tumor thrombus was showed 63 （42% ） , 35 （23 .33% ） , 25 （16 .67% ） was significantly higher than that in control group 38 （28 .79% ） ,17 （12 .88% ） ,11 （8 .33% ） ,more than two sets of each index statistics difference was statistically significance （P〈0 .05） .Conclusion It can improve the diagnostic image quality ,improve the accuratediagnosis rate ,reduce the adverse reaction occurred via hepatic artery CO 2-DSA .