原发性肝癌介入治疗前后肝脏及瘤体内血流动力学变化的研究  

Study of Hemodynamics of the Hepatic and Tumor Blood Flow before and after Transhepatic Artery Chemoembolization for Primary Hepatic Cell Carcinoma

作　　者：胡舜华[1,2] 杨绍珑[1,2] 章蓉 王占春[1,2] 张秀霞 

机构地区：[1]山东省青岛市立医院B超室 [2]山东省即墨市人民医院

出　　处：《中国超声医学杂志》1998年第8期38-40,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：应用彩色多普勒诊断仪对３６例原发性肝癌患者介入治疗前后肝脏及肿瘤内血流动力学变化进行测定和分析研究。发现本组原发性肝癌患者均为高供血性，肝固有动脉的内径、血流速度和血流量均明显高于正常人和其他肝脏病患者（Ｐ＜０．０５），肝癌患者的肝脏血供是以肝固有动脉血流量骤增为特点，当大于５００亳升／分时，有助于对肝内占位性病变的鉴别诊断。介入治疗（ＴｒａｎｓｈｅｐａｔｉｃＡｒｔｅｒｙＥｍｂｏｌｉｚａｔｉｏｎ，ＴＡＥ）后，肝脏的血流动力学发生明显变化。ＴＡＥ治疗后近期，肝脏血流量明显增加，并以肝固有动脉血流量骤减和门静脉血流量代偿性增加为其特点（Ｐ＜０．０５）。ＴＡＥ治疗后一个月，肝固有动脉血流进一步降低，且ＴＡＥ后近期代偿性增加的门静脉血流量也逐步降低、并恢复和接近治疗的水平（Ｐ＜０．０５）。肝脏和肿瘤的血供均明显减少，表现出正性治疗作用。本组均为巨块型肝癌，肿瘤内血流丰富，２６例为动脉血流，１０例为动静脉混合血流。ＴＡＥ治疗后，肿瘤的血流也发生明显变化，动脉血流减少或消失，变为静脉血流甚或无血流；血流分级发生明显变化，肿瘤血流中Ⅱ～Ⅲ级血供明显减少或消失（Ｐ＜０．０５）。但随ＴＡＥ后时间的延长，肿瘤血流又有不同程度增?The hemodynamics changes of HA,PV and tumour in 36 primary hepatic cell carcinoma(PHCC)cases wers studied with colour Doppler.It showed that the diameter,the velocity and the amout of blood flow of the hepatic artery were increased(P<0 05).The amount of blood flow of hepatic artery was >500 ml/min in all the PHCC cases,distinct<500 of the normal control.There was a remarkable change in both the liver and tumour hemodynamics before and after transhepatic artery embolization(TAE).One week after TAE,the diameter,the velocity and the amount of HA were decreased(P<0 05),but the diameter of PV had no change.Both the velocity and the amount of blood flow of PV were increased (P<0 01).The total amount of hepatic blood folw was increased also (P<0 05).One month after TAE,the diameter of HA and PV had no change as comparing with that of the early stage.Both the velocity and amount of blood flow of HA and PV as well as the total blood flow of the liver were decreased(P<0 05).After TAE,the blood supply of tumor was changed,including both arterial and venous being mixed or only venous supply in most cases.The tumor blood flow was decreased from grade II or III to 0 or I in most cases.The blood supply of the tumor mainly came from the artery and changed after embolization.

关 键 词：肝癌 介入治疗 血流动力学 

分 类 号：R735.705[医药卫生—肿瘤]