Embosphere微球联合平阳霉素碘化油乳剂经肝动脉栓塞治疗肝血管瘤的应用价值

Application Value of Embosphere Microspheres Combined with Pingyangmycin Iodized Oil Emulsion in the Treatment of Hepatic Hemangioma Through Hepatic Artery Embolization

目的:探讨应用Embosphere微球联合平阳霉素碘化油乳剂行肝动脉栓塞术介入治疗肝血管瘤的安全性和临床有效性。方法:对符合介入治疗标准的62例患者采用经导管肝动脉栓塞术(TAE)治疗,以粒径为100~300μm的Embosphere微球联合平阳霉素碘化油乳剂作为栓塞方案;记录术前肿瘤直径大小、肝功能生化指标值,观察患者术后表现与并发症情况,于术后1个月、3个月及6个月随访瘤体直径大小变化,术后7天和1个月复查肝功能生化指标。结果:62例入组患者TAE成功率为100%。术后1个月、3个月及6个月随访可见瘤体直径较术前显著减少,平均下降率分别为55.4%、56.8%和57.6%,差异有统计学意义(P<0.05),其临床有效率分别为96.7%、96.5%和98.1%。所有患者均未出现肝胆坏死及胆管狭窄等严重并发症,共11例出现发热、疼痛及胸闷、恶心呕吐等症状,不良反应总发生率为17.7%。术后7天肝功能AST、ALT水平明显升高,较术前差异有统计学意义(P<0.05);1个月后AST、ALT恢复到术前水平(P>0.05)。结论:Embosphere微球联合平阳霉素碘化油乳剂在肝动脉栓塞治疗肝血管瘤中安全性较高,疗效确切,值得在临床上推广和应用。

Objective:To evaluate the safety and clinical efficacy of Embosphere microsphere combined with pingyangmycin iodized oil emulsion for interventional treatment of hepatic hemangioma by hepatic artery embolization.Methods:62 patients who met the standard of interventional therapy were treated with transcatheter hepatic artery embolization(TAE),embosphere microspheres with particle size of 100~300μm combined with pingyangmycin iodized oil emulsion were used as the embolization scheme.Preoperative tumor diameter and biochemical indexes of liver function were recorded.The clinical symptoms and complications were observed.Changes in tumor diameter were followed up in 1,3and 6 months after operation.Biochemical indexes of liver function were reexamined 7 days and 1 month after the operation.Results:The success rate of TAE in 62 enrolled patients was 100%.Based on the follow-ups in 1,3 and 6 months,the tumor diameter was significantly reduced compared with that before surgery,the mean shrinkage rate was 55.4%,56.8%and 57.6%,respectively,the difference was statistically significant(P<0.05),the corresponding clinical response rates were 96.7%,96.5%and 98.1%,respectively.None of the patients had severe complications such as hepatobiliary necrosis and bile duct stricture,a total of 11 patients presented with fever,pain,chest tightness,nausea and vomiting,and the overall incidence of adverse reactions was 17.7%.Liver function AST and ALT were significantly increased 7 days after operation,the difference was statistically significant(P<0.05).AST and ALT returned to preoperative levels after 1 month(P>0.05).Conclusion:Embosphere microsphere combined with pingyangmycin iodized oil emulsion is safe in the treatment of hepatic hemangioma by hepatic artery embolization,its curative effect is valid,and it can be popularized and applied in clinical treatments.