肝动脉化疗栓塞术中碘油乳剂经微导管推注的优化研究

Optimization of lipiodol emulsion injection via microcatheter in performing transcatheter hepatic arterial chemoembolization

目的通过体外实验进行肝动脉化疗栓塞术(TACE)中碘油乳剂经微导管推注的优化研究。方法建立体外检测装置,使用3种不同微导管推注同种溶剂-碘油乳剂,分别测量在相同时间点微导管尖端的压力及推注出的碘油乳剂剂量;再使用同种微导管推注3种不同的溶剂-碘油乳剂,分别测量在相同时间点微导管尖端的压力及推注出的碘油乳剂剂量,收集所需数据进行比较与分析。结果相同时间内3种不同微导管推注同种溶剂-碘油乳剂时,Stride微导管尖端的压力及推注出的碘油乳剂量均最大,其次为Progreat微导管,Echelon微导管尖端的压力及推注出的碘油乳剂剂量均最小(P<0.01);相同时间内同种微导管推注3种不同溶剂-碘油乳剂时微导管尖端的压力及推注出的碘油乳剂剂量不同(P<0.01),且碘佛醇-碘油乳剂均为最小(P<0.01),而利多卡因-碘油乳剂与生理盐水-碘油乳剂之间无统计学差异(P>0.05)。结论选用Stride微导管及利多卡因-碘油乳剂将更易于碘油乳剂的推注,减少监视碘油乳剂推注时的X线透视时间,降低手术人员及患者的X线辐射剂量。

Objective To optimize the injection way of lipiodol emulsion via microcatheter in performing transcatheter hepatic arterial chemoembolization （TACE） through experiment in vitro. Methods Detection device used for experiment in vitro was established. Three types of microcatheter were used to inject the same solvent-lipiodol emulsion, the pressure at the catheter tip and the injected-out lipiodol emulsion volume of each type of microcatheter were separately measured at the same time point. Then, the same type of microcatheter was used to separately inject three different solvent-lipiodol emulsions, and the pressure at the catheter tip and the injected-out lipiodol emulsion volume were separately measured at the same time point. The required data were collected for comparison and analysis. Results Under the condition when the injection time of same solvent-lipiodol emulsion was the same, the pressure at the catheter tip and the injected-out lipiodol emulsion volume of Stride microcatheter were the largest, with those of Progreat microcatheter being the next and those of Echelon microcatheter being the smallest （P〈0.01）. Under the condition when the same type of microcatheter and the same injection time were employed, the differences in the pressure at the catheter tip and the injected- out lipiodol emulsion volume were statistically significant between each other among the three solvent-lipiodol emulsions （P〈0.01）, with those of ioversol-lipiodol emulsion being the smallest （P〈0.01）, while no statistically significant difference existed between the lidocaine-lipiodol emulsion and saline-lipiodol emulsion （P〉0.05）.Conclusion The using of Stride micrucatheter and lidocaine-lipiodol emulsion can make the injection of lipiodol emulsion easier, reduce the monitoring X-ray exposure time for lipiodol emulsion injection, and thus decrease the total radiation exposure dose to both operators and patients.