肝血管瘤治疗中不同介入栓塞方法的比较

Comparison of different embolization methods in the treatment of hepatic hemangioma

目的探讨不同介入栓塞方案治疗肝血管瘤的疗效及安全性。方法收集2010年8月-2013年4月在济宁市第一人民医院介入放射科接受治疗的肝血管瘤患者的临床资料。入组患者根据栓塞方法不同分为明胶海绵微粒+平阳霉素碘化油乳剂组(观察组)和单纯的平阳霉素碘化油乳剂组(对照组),比较两组患者的治疗效果、术后并发症、下床时间、住院时间以及治疗前后总胆汁酸(total bile acid,TBA)的变化。结果本研究共纳入研究对象60例,其中观察组和对照组各30例。观察组患者治疗有效率和显效率均优于对照组(χ2=6.734,P=0.034);两组并发症发生率差异无统计学意义(χ2=0.098,P=0.75),观察组下床时间(t=19.39,P<0.01)、住院时间(t=7.257,P<0.01)均显著少于对照组;治疗前两组患者TBA水平差异无统计学意义(t=0.073,P=0.94),治疗后3 d观察组TBA水平低于对照组(t=3.195,P<0.01)。两组患者的谷丙、谷草转氨酶、白蛋白、总胆红素、凝血酶原时间等指标均无统计学差异(P均>0.05)。结论明胶海绵微粒加平阳霉素碘化油乳剂相对于单纯平阳霉素碘化油乳剂治疗肝血管瘤,不仅有效、安全,而且患者术后恢复速度更快。

Objective To discuss the curative effect and safety of different embolization methods in the treatment of hepatic hemangioma. Methods Clinical data about patients with hepatic hemangioma received treatment in our hospital from 2010 to 2013 were retrospectively analyzed. According to the treatment, enrolled patients were divided into two groups： observe group （Gelatin sponge particles combined with Bleomycin iodized oil emulsion） and control group （simply Bleomycin iodized oil emulsion）. The effect of treatment, postoperative complications, hospitalization time, time of getting out of bed and the changes of TBA before and after the treatment in two groups were compared. Results A total of 60 patients were retrospectively analyzed, including 30 in control group and 30 in observe group. The effective rate of treatment and the marked effective rate of patients in observe group were better than those in control group. The differences had statistical significance （X^2=6.734, P=0.034）, while the differences in the incidence rate of complications had no statistical significance （ X^2=0.098, P--0.75）. The hospitalization time （t=7.257, P 〈 0.01） and the time of getting out of bed （t= 19.39, P 〈 0.01） in observe group were less than those in control group. The differences in the level of TAB had no statistical significance （t=0.073, P=0.94）. The level of TAB after treatment for 3 d was lower in observe group than those in control group （t=3.195, P 〈 0.01）. There was no statistical difference in alanine, aspartate aminotransferase, albumin, total bilirubin and prothrombin time between two groups. Conelusion Patients in observe group are not only effective and safe, but also have a faster postoperative recovery.