平阳霉素碘油乳剂治疗肝海绵状血管瘤疗效影响因素分析  

Intra-arterial embolization with pingyangmycin-lipiodol emulsion for the treatment of hepatic cavernous hemangioma: an analysis of factors affecting therapeutic results

作　　者：曾庆乐[1] 陈勇[1] 赵剑波[1] 张克伟[1] 李彦豪[1] 

机构地区：[1]广州南方医科大学南方医院介入治疗科,510515

出　　处：《介入放射学杂志》2009年第9期656-660,共5页Journal of Interventional Radiology

摘　　要：目的分析平阳霉素碘油乳剂动脉内栓塞治疗(PLE-IASE)肝海绵状血管瘤(SCHL)的影响因素。方法89例诊断明确的SCHL患者,瘤体直径为(8.3±3.8)cm。临床症状上仅有焦虑症状者53例,右上腹疼痛35例,Kasabach-Merrit综合征1例。PLE-IASE治疗前根据肝动脉造影表现进行动脉造影分型,分型确定后配制PLE经供血动脉注射。其中平阳霉素(PYM)用量为(9.8±4.4)mg,碘油(lipiodol,LP)用量为(5.9±2.9)ml。治疗结束后根据复查点片确定其碘油沉积状态。随访6～72个月,观察患者并发症发生情况,计算症状缓解率和瘤体缩小率。以瘤体缩小率为应变量,术前肿瘤直径、动脉造影分型、PYM用量、LP用量及碘油沉积状态为自变量,进行线性回归分析。结果89例患者动脉造影分型富血型51例,乏血型26例,动静脉分流(AVS)型12例。治疗后碘油沉积状态良好64例,不良25例。随访结束时53例焦虑患者症状缓解,35例右上腹疼痛者33例缓解,2例术后仍有间歇性疼痛。1例Kasabach-Merrit综合征术后血小板恢复正常。随访症状缓解率98.7%。随访期间未发生严重并发症。线性回归分析显示动脉造影分型、PYM用量及碘油沉积状态对瘤体缩小率有显著影响,而术前肿瘤直径及LP用量对瘤体缩小率无显著影响。结论PLE-IASE为一种安全有效的介入治疗方法,动脉造影分型、PYM用量及碘油沉积状态对瘤体缩小率有显著影响,而术前肿瘤直径及LP用量对瘤体缩小率无显著影响。Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization （PLE-IASE） in treating symptomatic cavernous hemangioma of liver （SCHL）. Methods PLE-IASE was performed in 89 patients with SCHL （32 males and 57 females）. Before treatment the mean diameter of the hemangioma was （8.3 ± 3.8） cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabaeh-Merrit syndrome. Before PLE-IASE, the arteriographie classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion （PLE） was injected through the feeding artery. The dosage of pingyangmycin （PYM） was （9.8± 4.4） mg and the dosage of lipiodol （LP） was （5.9± 2.9） ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervaseular type was seen in 51, hypovaseular type in 26 and arteriovenous shunt （AVS） type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression

关 键 词：肝海绵状血管瘤 平阳霉素 超液化碘油 栓塞 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]