两种不同栓塞剂超选择动脉栓塞治疗肝血管瘤的疗效比较

Efficacy comparsion of two different embolization agents in the treatment of hepatic hemangioma with superselective arterial embolization

目的探讨平阳霉素碘化油乳剂和栓塞微粒球两种不同栓塞剂超选择动脉栓塞治疗肝血管瘤的临床疗效差异。方法回顾性分析91例经两种栓塞剂超选择动脉栓塞治疗的肝血管瘤患者的临床资料,其中采用平阳霉素碘化油乳剂作为栓塞剂(甲组)51例,采用栓塞微粒球作为栓塞剂(乙组)40例,依据RECIST疗效评估标准评估两组治疗效果,同时观察患者不良反应及并发症情况。结果两组肝血管瘤患者在性别、年龄、肿瘤大小和个数方面差异无统计学意义(P>0.05)。患者栓塞治疗后6个月复查肝脏彩超或CT,两组总有效率为82.4%,甲组的有效率优于乙组(P<0.05)。两组栓塞后综合征多见但比较轻,经对症处理后均很快缓解,术后均未出现胆囊坏死、胆管狭窄和肝脓肿等严重并发症。结论两种栓塞剂超选择动脉栓塞治疗肝血管瘤均为安全、有效的选择,而平阳霉素碘化油乳剂较栓塞微粒球超选择动脉栓塞治疗肝血管瘤的近期疗效更确切。

Objective To investigate the difference of clinical efficacy of pingyangmycin lipiodol emulsion and embolismmicrospheres in the treatment of hepatic hemangiomas with superselective arterial embolization. Methods Retrospectiveanalysis of the clinical data of 91 cases of hepatic hemangiomas treated with two kinds of embolization agents withsuperselective arterial embolization was pefermed. The 51 patients who treated with pingyangmycin lipiodol emulsion asembolization agent were selected as the group A, and 40 patients who treated with embolization microspheres asembolization agent were selected as the group B. RECIST criteria was used to evaluate effects of the two treatments. Theadverse reactions and complications of the patients were observed at the same time. Results There were no significantdifferences in gender, age, tumor size and number of hemangiomas patients between the two groups（P〉0.05）. All the patientswere evaluated by hepatic Doppler ultrasound or CT at 6 months after embolization treatment. The total effective rate of bothgroups was 82.4% . The effective rate of the group A was better than that of the groupB （P 〈0.05）. The post-chemoemboilzation syndrome of the two group was common but mild, and which quickly relieved after symptomatic treatment.No serious complications such as gallbladder necrosis, bile duct stenosis and hepatic abscess occurred in both groups.Conclusion Both embolization agents superselective arterial embolization are safe and effective choices for the treatment ofhepatic hemangiomas. However, pingyangmycin lipiodol emulsion is more effective in short term than embolism microspheresuperselective arterial embolization in the treatment of hepatic hemangiomas.