经桡动脉入路和经股动脉入路肝动脉栓塞介入术治疗肝血管瘤的效果比较

Comparison of the therapeutic effect of transcatheter hepatic artery embolization via radial artery approach and femoral artery approach on hepatic hemangioma

目的分析经桡动脉入路和经股动脉入路肝动脉栓塞介入术治疗肝血管瘤的临床效果。方法队列研究。抽取2021年1月至2023年12月南阳市第一人民医院收治的70例肝血管瘤患者为研究对象, 按随机数字表法分为桡动脉入路组和股动脉入路组, 每组35例。两组均行肝动脉栓塞介入术, 桡动脉入路组采用经桡动脉入路手术, 股动脉入路组采用经股动脉入路手术。比较两组围术期情况、曝光时间、剂量面积乘积、肝功能[丙氨酸转氨酶(ALT)、总胆红素(TBIL)]、术后疼痛评分[视觉模拟评分法(VAS)评分]及并发症发生率。结果两组穿刺成功率、透视时间、造影时间比较差异未见统计学意义(P>0.05)。桡动脉入路组手术时间[(91.25±5.43)min]长于股动脉入路组[(79.17±4.75)min], 术后卧床时间[(1.04±0.19)d]短于股动脉入路组[(2.17±0.22)d], P<0.05。术后3 d, 两组ALT、TBIL水平均高于术前;术后7 d, 两组ALT、TBIL均恢复至术前水平, 但组间比较差异未见统计学意义(P>0.05)。术后1、6 h, 桡动脉入路组VAS评分均低于股动脉入路组(P均<0.05)。两组并发症发生率比较差异未见统计学意义(P>0.05)。结论肝血管瘤介入治疗中采用经桡动脉入路和经股动脉入路均可达到同样的治疗效果和安全性, 桡动脉入路的手术时间略长, 但能减少术后卧床时间。

Objective To analyze the clinical effect of transcatheter hepatic artery embolization via radial artery approach and femoral artery approach in the treatment of hepatic hemangioma.Methods This study was a cohort study.Seventy patients with hepatic hemangioma admitted to Nanyang First People’s Hospital from January 2021 to December 2023 were selected as the research subjects,and they were divided into the radial artery approach group and the femoral artery approach group according to the random number table method,with 35 cases in each group.Both groups underwent transcatheter hepatic artery embolization.The radial artery approach group underwent surgery via the radial artery approach,and the femoral artery approach group underwent surgery via the femoral artery approach.The perioperative conditions,exposure time,dose area product,liver function assessed by alanine transaminase(ALT)and total bilirubin(TBIL),postoperative pain scores assessed by visual analogue scale(VAS)score,and incidence of complications were compared between the two groups.Results There was no significant difference in the success rate of puncture,fluoroscopy time and imaging time between the two groups(P>0.05).The surgical time of the radial artery approach group was(91.25±5.43)min,which was longer than the(79.17±4.75)min of the femoral artery approach group(P<0.05);the postoperative bed rest time of the radial artery approach group was(1.04±0.19)d,which was shorter than the(2.17±0.22)d of the femoral artery approach group(P<0.05).On 3 days after surgery the levels of ALT and TBIL in both groups were higher than those before surgery;levels of ALT and TBIL in both groups returned to preoperative levels on 7 days after surgery,but there was no statistically significant difference between the two groups(P>0.05).At 1 and 6 hours postoperatively,the VAS scores of the radial artery approach group were lower than those of the femoral artery approach group(all P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions The use of both radial and femoral artery approaches in transcatheter hepatic artery embolization for hepatic hemangioma have comparable therapeutic effect and ideal safety.Surgery via the radial artery approach can prolong the surgical time to a certain extent,but can significantly reduce postoperative bed rest time.