肾癌介入治疗明胶海绵与碘油临床应用研究

Study on lipiodol and gelfoam embolization in intervene treatment for carcinoma of kidney

目的 对明胶海绵和碘油在肾癌介入治疗中的应用比较研究。方法 搜集 2 8例中晚期肾癌 ,其中肾癌 2 6例 ,2例为肾转移癌 ,Ⅰ期 2例 ,Ⅱ期 2 3例 ,Ⅲ期 2例 ,Ⅳ期 1例。选择性肾动脉插管造影确认肿瘤供血动脉 ,分别在肾动脉主干或超选择肿瘤血管支行明胶海绵与碘油化疗栓塞术治疗。结果 明胶海绵栓塞组 12例 ,均在肾动脉主干或超选择栓塞 ;碘油栓塞组 2 6例 ,超选择栓塞 14例 ,主干栓塞 2例 ,副肾动脉栓塞 2例。碘油栓塞组的有效率 (CR +PR)显著高于明胶海绵栓塞组织 (6 8.8%∶4 1.2 % ,P <0 .0 5 )。碘油栓塞组并发症发生率也显著高于明胶海绵组 (2 5 %∶8.3% ,P <0 .0 5 ) ,采用超选择性肿瘤血管内化疗栓塞者无并发症发生。结论 碘油化疗栓塞治疗肾癌的近期疗效优于明胶海绵化疗栓塞术。明胶海绵化疗栓塞术较为安全 ,但疗效欠佳 ,肾癌治疗应采用两种栓塞剂同时应用 ,对大部分肿瘤组织坏死起到较好作用 ,疗效肯定 ,便于随访观察。

Objective:To study of lipiodol and gelfoam embolization in intervene treatment for carcinoma of kidney.Methods:There were 28 cases in this group. 26 cases with carcinoma of kidney and 2 cases metastasis cancer; 2 cases, 2 cases, 23 cases, 1 case respectively belonged to Ⅰ, Ⅱ,Ⅲ,Ⅳ period.Results:Group A: 1 case in CR, 4 cases in PR,7 cases in SR, 0 cases in P, CR+PR occupied about 41.2%. Group B: 3case in CR, 8 cases in PR ,0 cases in P, CR+PR occupied about 68.8%.Conclusions:The effective rate of group B is notable superior to that of group A(P<0.05). The effect of lipiodol and gelfoam embolization of renal artery is positive, it is helpful to watch the process of embolization by image and is convenient to follow up.