超声引导下平阳霉素瘤体内注射与DSA引导下平阳霉素肝动脉栓塞治疗肝血管瘤对比分析

Ultrasound-guided pingyangmycin injection and DSA-guided pingyangmycin hepatic arterial embolization for treatment of hepatic hemangioma:A comparative analysis

目的对比分析超声引导下平阳霉素(PYM)瘤体内注射与DSA引导下PYM肝动脉栓塞治疗肝血管瘤的临床应用价值。方法收集50例肝血管瘤患者,对其中26例(超声组)行超声引导下PYM瘤体内注射治疗,24例(栓塞组)行DSA引导下PYM肝动脉栓塞治疗,对比两种治疗方法的治疗时间、费用、术后疗效及并发症情况。结果对50例患者均顺利完成治疗。超声组治疗时间[(10.54±3.33)min]及治疗费用[(2250.00±244.15)元]均明显低于栓塞组[(55.56±15.56)min及(12 555.56±2069.03)元],差异均有统计学意义(P=0.033、0.012)。超声组术后发热[15.38%(4/26)]及肝功能异常发生率[19.23%(5/26)]均低于栓塞组[70.83%(17/24),50.00%(12/24)],差异有统计学意义(P均<0.05);两组间术后肝区疼痛发生率[61.54%(16/26)vs 54.17%(13/24)]差异无统计学意义(P=0.775)。共59个肝血管瘤中,超声组31个,栓塞组28个。术后12个月,超声组及栓塞组治疗总有效率均为100%(31/31,28/28)。超声组瘤体平均缩小率[(93.10±6.85)%]明显高于栓塞组[(68.81±4.23)%],差异有统计学意义(P=0.004)。结论两种治疗方法效果均可靠,但超声引导下PYM瘤体内注射治疗肝血管瘤在治疗时间、费用、术后并发症及瘤体缩小率方面更具优势。

Objective To compare the clinical application value of ultrasound-guided pingyangmycin injection guided by ultrasound and pingyangmycin hepatic arterial embolization guided by DSA for treatment of hepatic hemangioma.Methods Totally 50 patients with hepatic hemangioma were enrolled,including 26 cases underwent ultrasound-guided pingyangmycin injection（ultrasound group）,and 24 cases underwent DSA-guided pingyangmycin hepatic arterial embolization（embolization group）.The treatment time,cost,postoperative treatment efficacy and complications were compared.ResultsThe treatments for all of 50 patients were successfully completed.The treatment time and cost of ultrasound group（[10.54±3.33]min and [2250.00±244.15]Yuan）were lower than those of embolization group（[55.56±15.56]min and [12555.56±2069.03]Yuan,P=0.033,0.012）.The incidence rates of postoperative fever and liver function abnormal in ultrasound group（15.38% [4/26]and 19.23% [5/26]）were lower than those in embolization group（70.83% [17/24]and50.00% [12/24],both P〈0.05）.No statistical difference of postoperative liver area pain was found between two groups（61.54% [16/26]vs 54.17% [13/24],P=0.775）.There were 31 hepatic hemangiomas in ultrasound group and 28 hepatic hemangiomas in embolization group.The total effectiveness of ultrasound group and embolization group were both100%（31/31,28/28）at 12 months after treatments.The average tumor shrink rate of ultrasound group（[93.10±6.85]%）was higher than that of embolization group（[68.81±4.23]%,P=0.004）.Conclusion The effect of the two treatments are both reliable,but pingyangmycin injection guided by ultrasound in treating hepatic hemangioma is better than pingyangmycin hepatic arterial embolization guided by DSA in the aspects of treatment time,cost,complications and tumor shrink rate.