肺癌支气管动脉化疗栓塞中利多卡因试验联合DSA-CT的应用价值

The application value of lidocaine experiment combined with DSA-CT in bronchial artery chemoembolization of lung cancer

目的探讨利多卡因试验联合DSA-CT在肺癌支气管动脉化疗栓塞术中的应用价值。方法回顾性收集2019年1月~2020年6月行支气管动脉化疗栓塞的44例肺癌患者的资料。所有患者采用DSA辅助下微导管超选肿瘤供血动脉,先进行利多卡因试验然后利用DSA-CT功能进行造影后的三维重建,确定有无支气管肋间动脉与脊髓根动脉共干及其共干位置。采用微导管进一步选择避开脊髓根动脉,再行肿瘤供血动脉的化疗栓塞。术后定期随访,对所有患者介入治疗效果、伴随症状、短期生存率进行评估。结果全组病例显效84.1%(37/44)、稳定11.4%(5/44)、无效4.5%(2/44);术后伴随症状减轻88.6%(39/44)、无明显变化9.1%(4/44)、加重2.2%(1/44);半年生存率90.9%(40/44)、1年生存率81.8%(36/44)。结论针对肺癌介入治疗的患者,术中使用利多卡因试验联合DSA-CT功能,大大提高支气管动脉栓塞成功率,有效控制肿瘤的局部进展、缓解临床症状、提高患者生活质量。

Objective To explore the application value of lidocaine experiment combined with DSA-CT in bronchial artery chemoembolization for lung cancer.Methods The data of 44 patients with lung cancer who underwent bronchial artery chemoembolization in our hospital from January 2019 to June 2020 were collected retrospectively.The tumor supplying arteries were superselected by microcatheter assisted by DSA in all the patients.The lidocaine experiment was performed first,and then the 3D reconstruction after angiography was performed by using the DSA-CT function,to determine whether there was a common trunk between bronchial intercostal artery and spinal root artery and its location.Microcatheter was used to further avoid the spinal root artery,and chemoembolization of the tumor supplying artery was performed.Postoperative regular follow-up was conducted to evaluate the interventional therapy effect,concomitant symptoms and short-term survival rate of all patients.Results In the whole group,the response rate was 84.1%(37/44),stable 11.4%(5/44)and ineffective 4.5%(2/44).Postoperative concomitant symptoms were reduced by 88.6%(39/44),not significantly changed by 9.1%(4/44)and aggravated by 2.2%(1/44).The half-year survival rate was 90.9%(40/44),and the one-year survival rate was 81.8%(36/44).Conclusion For patients undergoing interventional treatment of lung cancer,intraoperative lidocaine experiment combined with DSA-CT function can greatly improve the success rate of bronchial artery embolization,effectively control the local progression of tumor,alleviate clinical symptoms and improve the quality of life of patients.