CalliSpheres载药微球治疗原发性肝癌并发肝脓肿4例分析

Liver abscess formation caused by CalliSpheres beads treatment for primary liver cancer:analysis of 4 patients

目的探讨CalliSpheres载药微球治疗原发性肝癌并发肝脓肿的原因及治疗效果。方法回顾性分析4例原发性肝癌患者采用CalliSpheres载药微球行肝动脉化疗栓塞术(DEB-TACE)后并发肝脓肿的临床资料,分析肝脓肿发生的原因,总结治疗方案及预后。结果4例患者均在彩超引导下行经皮肝穿刺脓腔引流术,脓液行细菌培养及药敏试验,脓液分别培养出表皮葡萄球菌、产气荚膜梭菌、脆弱拟杆菌、普通变形杆菌,经抗菌药物及引流治疗后临床症状均缓解,脓腔吸收2例,明显缩小2例。3例患者随访6~12个月存活,1例患者于引流术后3个月因脑梗死死亡。结论CalliSpheres DEBTACE治疗原发性肝癌可并发肝脓肿且原因较多,采用经皮穿刺脓肿引流可取得较好的治疗效果。

Objective To investigate the causes of liver abscess formation caused by CalliSpheres drug-eluting beads(DEB)treatment for primary liver cancer,and to discuss its management and curative effect.Methods The clinical data of 4 patients with primary liver cancer,who developed liver abscess after receiving CalliSpheres DEB transcatheter arterial chemoembolization(TACE),were retrospectively analyzed.The causes of liver abscess formation were analyzed,and the therapeutic scheme and prognosis of liver abscess were summarized.Results Under the guidance of color Doppler ultrasound,percutaneous transhepatic abscess drainage was performed in all the 4 patients.Pus was used for bacterial culture and drug sensitivity test.The abscesses were flushed with antibiotics.Through cultivation of pus,staphylococcus epidermidis,clostridium perfringens,bacteroides fragilis and common proteus were separately detected in the 4 patients’pus.After percutaneous transhepatic catheter drainage and antibiotic lavage,the clinical symptoms caused by liver abscess were dramatically improved.The liver abscesses were absorbed in 2 patients and significantly diminished in the other 2 patients.Three patients have lived during the follow-up of 6,6 and 12 months respectively after abscess drainage,and one patient died of cerebral infarction 3 months after drainage.Conclusion The liver abscess occurring after CalliSpheres DEB-TACE treatment for primary liver cancer may be caused by many reasons.Percutaneous transhepatic drainage of abscess can achieve favorable therapeutic effect.