博来霉素碘化油乳剂联合明胶海绵颗粒在肝血管瘤肝动脉栓塞中的临床研究

Clinical study of bleomycin iodized oil emulsion combined with gelatin sponge granules in transcatheter arterial embolization treatment of hepatic hemangioma

目的 探讨博来霉素碘化油乳剂联合明胶海绵颗粒在肝血管瘤肝动脉栓塞(transcatheter arterial embolization, TAE)中的临床效果及对并发症发生率的影响。方法 选取2015年8月至2021年12月我院介入医学科诊治的肝血管瘤患者80例为研究对象,所有患者均行TAE治疗,随机数字表法分为两组,每组各40例。对照组采用博来霉素碘化油乳剂治疗,观察组联合明胶海绵颗粒干预,两组治疗术后完成6个月门诊随访,比较两组手术有效率、手术指标、肝肾功能、总胆汁酸、血管瘤大小及术后并发症发生率。结果 观察组手术6个月后有效率为97.50%,高于对照组的85.00%(P<0.05);两组术后6个月瘤体直径均缩小;观察组瘤体直径低于对照组(P<0.05);两组术前及术后6个月Scr、BUN、ALT、AST水平差异无统计学意义(P>0.05);两组术后6个月TBA水平均低于术前(P<0.05),观察组术后6个月TBA水平低于对照组(P<0.05);两组围术期发热、术后感染、肝区疼痛、胆心反射及恶心呕吐发生率差异均无统计学意义(P>0.05)。结论 博来霉素碘化油乳剂联合明胶海绵颗粒用于肝血管瘤TAE患者中,能获得较高的有效率,手术创伤较小,对患者肝肾功能影响较小,能改善总胆汁酸水平,可缩小血管瘤,未增加术后并发症发生率,值得临床推广应用。

Objective To investigate the clinical effect of bleomycin iodized oil emulsion combined with gelatin sponge granule in transcatheter arterial embolization(TAE)of hepatic hemangioma and its influence on complication rate.Methods A total of 80 patients with hepatic hemangioma diagnosed and treated in the Department of Interventional Medicine of our hospital from Aug.2015 to Dec.2021 were selected as subjects.All patients received TAE treatment and were randomly divided into two groups with 40 cases in each group.The control group was treated with bleomycin iodized oil emulsion,and the observation group was treated with gelatine sponge granules.The two groups completed 6 months of outpatient follow-up after treatment.The surgical response rate,surgical indexes,liver and kidney function,total bile acid,hemangioma size and postoperative complication rate were compared between the two groups.Results Six months after operation,the effective rate of observation group(97.50%)was higher than that of control group(85.00%)(P<0.05).Tumor diameter was decreased 6 months after operation in both groups.The tumor diameter of observation group was lower than that of control group(P<0.05).There were no statistical differences in the levels of Scr,BUN,ALT,AST between the two groups before and 6 months after surgery(P>0.05).The TBA levels in both groups before surgery were lower than that 6 months after surgery(P<0.05),and the TBA level in the observation group was lower than that in the control group 6 months after surgery(P<0.05).There were no statistical differences in perioperative fever,postoperative infection,hepatic pain,biliary reflex,nausea and vomiting between the two groups(P>0.05).Conclusion Bleomycin iodized oil emulsion combined with gelatin sponge granules in hepatic hemangioma TAE patients can achieve a higher effective rate,less surgical trauma,little influence on the liver and kidney function of patients,can improve the level of total bile acid,can reduce the size of hemangioma,and does not increase the incidence of postoperative complications,worthy of clinical application.