CAJ | 학술논문

目的：探讨肝癌破裂出血应用Embosphere栓塞微球的微创介入治疗。方法采用Seldinger技术,使用Embosphere栓塞微球作为栓塞剂,对203例肝癌破裂出血患者行肝动脉超选择性栓塞止血。结果203例肝癌破裂出血患者急诊肝动脉栓塞后，198例均显示有效止血。另有4例患者再次有活动性出血（2例经再次栓塞止血病情控制，另1例栓塞不完全5天后死于失血性休克,1例再次造影仍未见有明确出血血管而行“盲栓”，48小时内死于失血性休克，考虑为静脉性出血可能），1例患者因出血前肝功能较差，栓塞2周后死于肝功能衰竭。结论经肝动脉注入栓塞微球栓塞出血肝动脉支可作为抢救肝癌破裂出血的有效手段，超选择性栓塞对患者肝功能影响甚微，不良反应小，特别适用于肝功能较差不能耐受手术者。
목적：탐토간암파렬출혈응용Embosphere전새미구적미창개입치료。방법채용Seldinger기술,사용Embosphere전새미구작위전새제,대203례간암파렬출혈환자행간동맥초선택성전새지혈。결과203례간암파렬출혈환자급진간동맥전새후，198례균현시유효지혈。령유4례환자재차유활동성출혈（2례경재차전새지혈병정공제，령1례전새불완전5천후사우실혈성휴극,1례재차조영잉미견유명학출혈혈관이행“맹전”，48소시내사우실혈성휴극，고필위정맥성출혈가능），1례환자인출혈전간공능교차，전새2주후사우간공능쇠갈。결론경간동맥주입전새미구전새출혈간동맥지가작위창구간암파렬출혈적유효수단，초선택성전새대환자간공능영향심미，불량반응소，특별괄용우간공능교차불능내수수술자。
Objective To investigate the ruptured hepatocellular carcinoma with minimally invasive interventional treatment of Embosphere microspheres. Methods Using Seldinger technology, the use of micro catheter implantation of Embosphere microspheres as embolization agents, 203 cases of ruptured hepatocellular carcinoma were treated by hepatic artery super selectiveembolization. Results 203 cases of ruptured hepatocellular carcinoma patients after emergency hepatic artery embolism, 198 cases showed effective hemostasis. Another 4 patients were again active bleeding (2 cases were cured by embolization of disease control, the other 1 cases of incomplete embolism 5 days later died of hemorrhagic shock, 1 cases of repeated angiography is still no clear bleeding vascular line"blind bolt", 48 h died of hemorrhagic shock, consider to venous bleeding may vary) in 1 cases, preoperative liver function is poor, died of liver function failure after two weeks. Conclusion Injection of microspheres via hepatic artery super selective embolism and hemorrhage of liver artery can be used as an effective measure to rescue the ruptured hepatocellular carcinoma, Embosphere microspheres have good histocompatibility, uniform, accurate, complete with embolization, the expansion coefficient is small, the advantages of permanent embolism, super selective embolization has little effect on the liver function of patients, adverse reaction small, especially suitable for the poor liver function patients who cannot tolerate operation.