中外健康文摘
中外健康文摘
중외건강문적
WORLD HEALTH DIGEST
2014年
20期
71-72
,共2页
肝癌%动静脉瘘%肝动脉内化疗栓塞术%肝动脉内化疗术
肝癌%動靜脈瘺%肝動脈內化療栓塞術%肝動脈內化療術
간암%동정맥루%간동맥내화료전새술%간동맥내화료술
hepatocelular carcinoma%Hepatic arterial-portal venous shunts%transcatheter arterial chemoembolization (TACE)%transcatheter arterial infusion(TAI)
目的：探讨肝癌合并动静脉瘘的介入治疗方法。方法回顾性分析34例肝癌患者行DSA造影，判断有无动静脉瘘，再根据实际情况选择实行肝动脉内化疗栓塞治疗或肝动脉内化疗术，比较两者之间的疗效。结果 DSA诊断肝癌合并动静脉瘘者11例，中央型动门静脉瘘6例，周围型动门静脉瘘4例，混合型1例，9例行肝动脉内化疗栓塞术，2例行肝动脉内化疗术。术后，所有患者肝功能均有不同程度好转，行肝动脉内化疗栓塞术中位生存时间，2月、6月、1年总体累积生存率均高于肝动脉内化疗术患者。结节型及巨块型肝癌中位生存时间，2月、6月、1年总体累积生存率相当，且均明显高于弥漫型肝癌。结论周围型、动静脉瘘的患者封堵瘘口较容易，而中央型动静脉瘘患者封堵瘘口难度较大，应尽量使用栓塞剂有效封堵瘘口血流或使用微导管绕过瘘口后再行TACE，如无法有效处理瘘口，则仅行TAI。
目的：探討肝癌閤併動靜脈瘺的介入治療方法。方法迴顧性分析34例肝癌患者行DSA造影，判斷有無動靜脈瘺，再根據實際情況選擇實行肝動脈內化療栓塞治療或肝動脈內化療術，比較兩者之間的療效。結果 DSA診斷肝癌閤併動靜脈瘺者11例，中央型動門靜脈瘺6例，週圍型動門靜脈瘺4例，混閤型1例，9例行肝動脈內化療栓塞術，2例行肝動脈內化療術。術後，所有患者肝功能均有不同程度好轉，行肝動脈內化療栓塞術中位生存時間，2月、6月、1年總體纍積生存率均高于肝動脈內化療術患者。結節型及巨塊型肝癌中位生存時間，2月、6月、1年總體纍積生存率相噹，且均明顯高于瀰漫型肝癌。結論週圍型、動靜脈瘺的患者封堵瘺口較容易，而中央型動靜脈瘺患者封堵瘺口難度較大，應儘量使用栓塞劑有效封堵瘺口血流或使用微導管繞過瘺口後再行TACE，如無法有效處理瘺口，則僅行TAI。
목적：탐토간암합병동정맥루적개입치료방법。방법회고성분석34례간암환자행DSA조영，판단유무동정맥루，재근거실제정황선택실행간동맥내화료전새치료혹간동맥내화료술，비교량자지간적료효。결과 DSA진단간암합병동정맥루자11례，중앙형동문정맥루6례，주위형동문정맥루4례，혼합형1례，9례행간동맥내화료전새술，2례행간동맥내화료술。술후，소유환자간공능균유불동정도호전，행간동맥내화료전새술중위생존시간，2월、6월、1년총체루적생존솔균고우간동맥내화료술환자。결절형급거괴형간암중위생존시간，2월、6월、1년총체루적생존솔상당，차균명현고우미만형간암。결론주위형、동정맥루적환자봉도루구교용역，이중앙형동정맥루환자봉도루구난도교대，응진량사용전새제유효봉도루구혈류혹사용미도관요과루구후재행TACE，여무법유효처리루구，칙부행TAI。
Objective To explore the interventional therapeutic methods for hepatocelular carcinoma accompanied with arteriovenous shunt. Methods 34 cases with proved hepatocelular carcinoma(HCC) were underwent DSA firstly, judge whether to exist Hepatic arterial-portal venous shunts. then transcatheter arterial chemoembolization (TACE) or transcatheter arterial infusion (TAI) were performed in al cases . we compared with the therapeutic effect of TACE with the one of TAI. Results Totaly 11 cases were presented with arteriovenous shunt, including 6 cases with hepatic artery-portal vein shunts of central type, 4 cases with the ones of peripheral type, 1 cses with the ones of mixed type. Hepatic function was improved after interventional therapy. The median survival time,two months survival rate, six months survival rate and one year survival rate of the case received TACE were higher than the cases received TAI. The ones of huge hepatic carcinoma and nodulous hepatic carcinoma were higher than the ones of asystematic hepatic carcinoma. The ones of huge hepatic carcinoma were similar with the ones of nodulous hepatic carcinoma. Conclusion The blockings of hepatic artery-portal vein shunts of peripheral type, are easier than the ones of central type. When we succeed to blocking the hepatic artery-portal vein shunts and use micro catheter to bypass the hepatic artery-portal vein shunts , TACE is used but the hepatic artery-portal vein shunts has to be treated with TAI only.
