经左锁骨下动脉插管在肝癌TAE中的意义  

Significance of Catheterization Through Left Subclavian Artery Puncture in Chemoembolization for Liver Cancer

作　　者：罗鹏飞[1] 邵培坚[1] 马壮[1] 陈晓明[1] 

机构地区：[1]广东省人民医院肿瘤科

出　　处：《实用放射学杂志》1998年第3期140-142,共3页Journal of Practical Radiology

摘　　要：目的：研究经左锁骨下动脉入路插管对某些非正常型血管分布的肝癌患者在ＴＡＥ技术操作中的意义。方法：１０５例均为首次经股动脉插管未能超选择插管成功者。其中Ａ组，即腹腔动脉（ＣＡ）干长于２．５ｃｍ者５８例，Ｂ组即肝动脉开口于肠系膜上动脉（ＳＭＡ）者４０例，Ｃ组即开口于ＣＡ的肝总动脉已闭塞，由源于ＳＭＡ的胰十二指肠下动脉侧支供血者７例。经左锁骨中外１／３交点下２ｃｍ处向内上方向约３０°角穿刺左锁骨下动脉，用ｓｅｌｄｉｎｇｅｒ法把导管顺向引入肝固有动脉或侧支供血动脉，然后再行ＴＡＥ。结果：由于自上而下插管，易克服长ＣＡ或ＳＭＡ对导管短攀的反向力度，故１０５例均获超选择成功。结论：Ａ、Ｂ二组患者已占全部肝癌患者约４０％～５０％，熟悉经左锁骨下动脉途径插管对提高超选择技术有意义。Objective:To investigate the significance of catheterization through percutaneous left subclavian artery(LSA) puncture in the chemoenbolization of liver cancer with variant blood supply.Methods:105 cases of liver cancer who were underwent the first unsuccessful catheterization through artery percutaneous femoral artery puncture were divided into three group:group artery A(n=58) had a long celiac trunk artery(>2.5 cm);Group B(n=40) had a aberrant hepatic artery originating from superior mesenteric artery (SMA);and group C(n=7) had a collateral circulation blood supply from inferior pancreaticoduodenal artery orignatinag SMA,common hepatic artery was ccluded.Using Seldinger′s technique,percutaneouslly via LSA puncture the 5F Cobra catheter tip was introduced anterogradelly into the proper hepatic artery or collateral feeding artery,then TAE was dene.Results:The superselective catheterizations into the tagged artery were successful in all 105 cases,becauee the catherigation was from top to bootom that may conquer the reacting force due to short catheter loop.from the long trunk of celiac artery or SMA.Conclusion:It′s important to familiarize oneself with the catheterization via LSA puncture for improving superselective catheterization skill,because the cases both in group A and B.consist of 40-50 percent of all patients of liver cancer.

关 键 词：肝肿瘤 药物疗法 栓塞疗法 TAE 

分 类 号：R735.705[医药卫生—肿瘤]