肝癌合并动静脉瘘的影像诊断及介入治疗

Imaging Diagnosis and Interventional Therapy of Hepatic Carcinoma with Arteriovenous Fistula

目的:探究肝癌合并动静脉瘘的诊断方法及介入治疗效果。方法:本文选取本院在2016年7月份至2017年8月份收治的肝癌合并动静脉瘘患者46例,采用血管造影(DSA)进行检查,运用DSA对肝动脉-静脉瘘进行诊断,结合HAPS的造影表现来了解患者病情具体情况,为疾病治疗提供依据。结果 :HAPS数字减影血管造影所诊断出来的例数最高,其次为HAVS数字减影血管造影诊断方法,混合型诊断出来的例数最低,各类型诊断方法所诊断出来的例数具有统计学差异(P<0.05);对23例患者进行卡铂、丝裂霉素、碘油乳剂栓塞者,13例患者运用碘油来完成对患者瘤体的填充。有5例患者行经皮肝穿刺胃冠状静脉栓塞手术,出血在术后1d后停止。有27例患者腹水明显减轻,有19例患者食管下段静脉曲张现象明显减轻;术前应为患者注射1%2-3m L的利多卡因,术后开展护肾及保肝治疗工作,无患者出现并发症及毒副反应。结论:DSA是肝癌合并动静脉瘘的主要检查手段,为栓塞治疗提供了可靠的治疗依据。

Objective:To analyze diagnosis and intervention study effect of hepatocellular carcinoma complicated with arteriovenous fistula.Methods:To select46paitients of ateriovenous fistula from2016.7to2017.8with angiography(DSA)inspected and diagnosis,and provide data based on HAPS wilt.Results:HAPS diagnosed by digital subtraction angiography patients were the highest,mixed type diagnosed patients were the lowest,various types of diagnostic methods diagnosed with statistical difference(P<0.05);carboplatin,mitomycin and lipiodol on23patients,13patients with lipiodol to complete filling in patients with tumor.5patients underwent percutaneous transhepatic puncture of the gastric coronary vein,and the bleeding stopped after1d.There were27cases of ascites obviously reduced,19cases of esophageal varices decreased significantly.Preoperative injection of lidocaine1%2-3mL should be performed before operation.After operation,there were no complications and side effects.Conclusion:DSA is the main examination method of hepatocellular carcinoma complicated with arteriovenous fistula,and provide a reliable basis for the treatment of embolization.