超选择性肝动脉栓塞术治疗多囊性肝病初步研究

Transcatheter super-selective hepatic arterial embolization for the treatment of polycystic liver disease:a preliminary study

目的 探讨超选择性肝动脉栓塞术（TAE）治疗多囊性肝病（PLD）的安全性及临床疗效。方法 2011年10月至2013年10月,采用栓塞微粒球Embosphere誖对14例有明显临床症状的PLD患者施行超选择性TAE术,其中女性11例,男性3例;年龄42～65岁,平均（48±5）岁。术前和术后每3个月行CT肝扫描,同时复查血常规、肝功能。结果 TAE技术成功率为100%。术后随访12～24个月,12例症状明显缓解,2例无效,有效率为85.7%。术后患者症状开始缓解时间平均为（3.2±1.1）个月。术后18个月时CT随访显示肝脏总体积、囊肿总体积较术前分别缩小（19.3±5.6）%、（20.4±7.8）%,差异有统计学意义（P〈0.05）。术后患者转氨酶呈一过性升高,无严重并发症发生。结论 采用栓塞微粒球行超选择性TAE治疗PLD疗效可靠、安全性高,可作为传统治疗手段的补充,值得临床推广应用。

Objective To evaluate the efficacy and safety of transcatheter super-selective hepatic arterial embolization （TAE） in treating polycystic liver disease. Methods During the period from Oct. 2011 to Oct. 2013, a total of 14 patients with symptomatic polycystic liver disease were admitted to authors＇ hospital to receive transcatheter super-selective hepatic TAE by using Embosphere microspheres. The patients included 11 females and 3 males with a mean age of （48±5） years （42-65 years）. CT scan of the liver was performed in all patients before TAE and once every three months after TAE, laboratory tests such as routine blood examination and liver function were also conducted. Results The technical success rate of TAE was t00%. All the patients were followed up for 12-24 months; obvious improvement of the clinical symptoms was obtained in 12 cases, and the treatment was invalid in 2 cases; the effective rate was 85.7%. The average time of patient＇s symptom starting to ease after TAE was （3.2±1.1） months. Follow-up CT scan performed at 18 months after TAE showed that the total volume of the liver, the total volume of the liver cysts were reduced by （19.3±5.6）% and （20.4±7.8）% respectively when compared with pretreatment data, the differences were statistically significant （P〈0.05）. After TAE, a transient elevation of aminotransferase was observed in all patients, and no severe complications occurred. Conclusion For the treatment of polycystic liver disease, transcatheter super-selective hepatic arterial embolization with microspheres is reliable and highly safe. As a supplemental option to traditional therapy, this technique is worthy of clinical application.