肾动脉化疗栓塞术治疗肾癌的疗效分析  

Eff icacy analysis of renal artery chemoemboliation in the treatment of renal carcinoma

作　　者：赵书元 王赢 程喆 徐海亮 

机构地区：[1]河南省驻马店市中心人民医院放射科,河南463000 [2]河南省驻马店市中心人民医院泌尿外科,河南463000

出　　处：《当代医学》2009年第11期185-187,共3页Contemporary Medicine

摘　　要：目的观察肾癌肾动脉化疗栓塞术后的疗效。方法对7例拟行手术切除的肾癌患者,术前用表阿霉素加丝裂霉素混合碘化油乳剂进行肿瘤末梢动脉栓塞,用明胶海绵栓塞肾动脉主干,3～7天进行手术切除。12例不愿意接受手术或不能手术的患者先进行化疗药物灌注,然后用无水酒精加碘油(1:1)进行肿瘤末梢动脉栓塞,每月1次,2次结束后评价疗效。结果7例手术患者肿瘤不同程度缩小,肾表面侧支血供少,部分瘤体坏死,颜色转为暗红色,肾表面静脉萎陷,肾周见明显水肿带,容易分离,手术出血少,手术时间明显缩短。12例行永久栓塞患者,临床症状缓解率87.5%,有效率(CR+PR)66.7%,近期受益率91.7%。部分病人出现栓塞后综合症,对症处理后多在1周内缓解。结论肾动脉栓塞化疗术作为肾肿瘤切除的术前准备,可以提高手术安全性及成功率;而作为晚期肾癌的姑息治疗手段,可以缓解症状,改善病人的生存质量,是治疗中晚期肾癌的一种安全、有效的治疗方法。Objective To observe the curative effect of preoperative renal artery chemoembolization in treating renal carcinoma. Method 7 cases intended to be surgically resected were embolized preoperatively. Epirubicin and mitomycin mixed with lipiodol emulsion was used in embolizing peripheral artery and gelatin sponge in renal artery trunk. Then surgery was carride out within 3-7 days. Twelve cases who refused operation or can＇t accept operation were monthly treated with perfusion chemotherapy and embolization in arteries supplying tumor with anhydrous alcohol and iodipin（1：1）. The efficacy was evaluated after two treatments. Results For 7 operative cases, the size of the carcinoma were decreased in different level, superficial feeding arteries decreased, part of the carcinoma was necrotic and its surface turned to dull red. The peripheral superficial veins shrinked, the perivenal edema zone was formed and easy to strip. It was effective to decrease operative bleeding and shorten the time of opetation. For 12 simple embolization cases, the remission rate of symptoms was 87.5%, the effective rate（CR＋PR） was 66.7%, and th.e short-term benefit rate was 91.7%. Some patients manifested with postembolization syndrome, which alleviated rapidly during 1-week heteropathy. Conclusion The renal artery embolization chemotherapy might be done preoperatively for large renal carcinoma to increase the safety and successful rate of operation and could relief the symptom and improve the life quality safely and effectively.

关 键 词：肾癌 肾动脉化疗栓塞术 临床治疗 疗效 

分 类 号：R737.11[医药卫生—肿瘤]