经导管选择性门静脉栓塞治疗肝癌的临床应用  

Transcatheter selective portal vein embolization in treatment of hepatocellular carcinoma: an analysis of 20 cases

作　　者：李建军[1] 杨维竹[1] 江娜[1] 黄兢姚[1] 郑曲彬[1] 黄宁[1] 杨升[1] 

机构地区：[1]福建医科大学附属协和医院介入科,福建省福州市350001

出　　处：《世界华人消化杂志》2004年第10期2291-2294,共4页World Chinese Journal of Digestology

基　　金：福建省卫生厅青年科研课题资助项目;No.2004-1-5~~

摘　　要：目的:探讨经导管选择性门静脉栓塞(PVE)在肝癌治疗中的临床应用价值.方法:20例不能手术切除的晚期肝癌患者,在电视透视引导下经导管行门静脉右支栓塞.栓塞前、后用CT测量左侧肝叶的体积,并测量栓塞前后的门静脉压力,监测肝功能和凝血功能的变化.结果:20例患者均成功行门静脉右支栓塞,PVE术后左侧肝叶代偿增生明显,13例(65%)在PVE后4wk内左侧肝叶占整个肝脏的百分比达到或几乎达到了25%,为手术切除创造了条件,其中1例PVE后顺利实行右肝切除术.PVE后未出现门静脉高压,肝功能损害轻,均无并发症出现.结论:经导管选择性门静脉栓塞能诱导肝叶代偿性增生,增加手术切除率,提高手术切除的安全性,对于大量无法手术切除的肝癌患者的治疗,具有广泛的临床应用价值.AIM: To evaluate the clinical value of transcatheter selective portal vein embolization (PVE) in treatment of hepa tocellular carcinoma. METHODS: Twenty patients, with unresectable advanced hepatocellular carcinoma, were treated with right PVE under fluoroscopic guidance. Left hepatic lobe volume was obtained by computerized tomography (CT) before and after PVE. Portal venous pressure, hepatic and thromboplastic functions were also detected before and after PVE. RESULTS: Right portal vein were embolized successfully in 20 patients. Compensatory hypertrophy was observed in left hepatic lobe. The volume of left hepatic lobe increased significantly with a total percentage of 25% in 13 patients (65%) at 4 wk after PVE (P<0.01). Right hepatic lobe was successfully resected in 1 patient. No patients had complications such as portal hypertension after PVE. Slight damage of liver function after PVE was observed. CONCLUSION: PVE can induce compensatory hypertrophy of liver lobes, which provides another operation chance for patients with unresectable hepatocellular carcinoma.

关 键 词：经导管选择性门静脉栓塞 治疗 肝癌 的临床应用 

分 类 号：R735.7[医药卫生—肿瘤]