• 四川大學華西醫(yī)院腫瘤中心腹部腫瘤科,四川成都 610041;

目的:探討經(jīng)肝動脈導管注射明膠海綿碘化油乳劑治療肝癌合并嚴重動靜脈瘺的可行性及臨床應(yīng)用價值。方法:對38例肝癌動靜脈瘺患者血管分別行超選擇插管注射明膠海綿碘化油乳劑,造影觀察動靜脈瘺的栓塞率,血管再通率,副作用,并發(fā)癥及生存率等指標。結(jié)果:38例肝癌動靜脈瘺患者經(jīng)肝動脈導管注入明膠海綿碘化油乳劑約2~10mL栓塞,栓塞后造影顯示閉塞率為94.7%(36/38),4周后造影顯示動靜脈瘺再通率為5.56%(2/36),未見確切不良反應(yīng),腫瘤碘化油乳劑沉積好,患者6月生存率為94.7%(36/38),12月生存率為60.5%(23/38),24月生存率為21.1%(8/38)。結(jié)論:經(jīng)肝動脈導管注射碘化油乳劑治療肝癌動靜脈瘺安全可靠,對瘺口要求不高,栓塞率高,再通率低,腫瘤的栓塞治療效果好。

引用本文： 李俊,廖正銀,游昕,羅勇. 明膠海綿碘化油乳劑栓塞治療肝癌動靜脈瘺的臨床應(yīng)用. 華西醫(yī)學, 2009, 24(5): 1193-1195. doi: 復制

版權(quán)信息： ?四川大學華西醫(yī)院華西期刊社《華西醫(yī)學》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1.
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3. KIDO C, SASAKI T, KANEKO M. Angiography of primary liver cancer[J]. Am J Roentgenol Radium Ther Nacl Med,1971,113:7081.
4. NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
5. OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
6. FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
7. OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
8. LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
9. 汪邵平,徐位頓,霍楓,等,肝癌合并動靜脈瘺71例的診治體會[J].中華普通外科雜志,2003,18:8486.
10. KIM Y J, LEE H G, PARK J M, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts[J]. Korean J Radiol,2007,8:311319.
11. TARAZOV P G. Intrahepatic arterioportal fistulae: role of transcatheter embolization[J]. Cardiovasc Intervent Radiol,1993,16:368373.
12. CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
13. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
14. 張電波,肖湘生.肝癌伴肝動—靜脈瘺的血管造影表現(xiàn)及其臨床意義[J].中國醫(yī)學影像雜志2001,9(5):356357.
15. VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
16. LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
17. 劉崎,田建明,賈雨辰,等.肝癌并門脈主干癌栓的介入治療及其預后的影響因素[J].中華放射學雜志,1999,33(8):538541.
18. 羅鵬飛,陳曉明,張良明,等.肝癌合并動靜脈瘺的處理方法探討[J].中華放射學雜志,2002,36(2):114117.
19. 關(guān)守海,單鴻,姜在波,等.經(jīng)微導管局部灌注無水乙醇治療肝癌高流量性動靜脈瘺[J].中華放射學雜志,2002,36:9971000.
20. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.
  1. 1.
  2. 2.
  3. 3. KIDO C, SASAKI T, KANEKO M. Angiography of primary liver cancer[J]. Am J Roentgenol Radium Ther Nacl Med,1971,113:7081.
  4. 4. NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
  5. 5. OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
  6. 6. FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
  7. 7. OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
  8. 8. LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
  9. 9. 汪邵平,徐位頓,霍楓,等,肝癌合并動靜脈瘺71例的診治體會[J].中華普通外科雜志,2003,18:8486.
  10. 10. KIM Y J, LEE H G, PARK J M, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts[J]. Korean J Radiol,2007,8:311319.
  11. 11. TARAZOV P G. Intrahepatic arterioportal fistulae: role of transcatheter embolization[J]. Cardiovasc Intervent Radiol,1993,16:368373.
  12. 12. CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
  13. 13. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
  14. 14. 張電波,肖湘生.肝癌伴肝動—靜脈瘺的血管造影表現(xiàn)及其臨床意義[J].中國醫(yī)學影像雜志2001,9(5):356357.
  15. 15. VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
  16. 16. LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
  17. 17. 劉崎,田建明,賈雨辰,等.肝癌并門脈主干癌栓的介入治療及其預后的影響因素[J].中華放射學雜志,1999,33(8):538541.
  18. 18. 羅鵬飛,陳曉明,張良明,等.肝癌合并動靜脈瘺的處理方法探討[J].中華放射學雜志,2002,36(2):114117.
  19. 19. 關(guān)守海,單鴻,姜在波,等.經(jīng)微導管局部灌注無水乙醇治療肝癌高流量性動靜脈瘺[J].中華放射學雜志,2002,36:9971000.
  20. 20. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.