植入^(125)I籽源条及金属支架联合经动脉化疗栓塞治疗肝癌合并下腔静脉梗阻的初步经验  

Implantation of radioactive ^(125)I seed strand and metallic stent combined with TACE for the treatment of HCC with IVC obstruction:initial results in 8 patients

作　　者：罗剑钧[1] 颜志平[1] 王建华[1] 刘清欣[1] 瞿旭东[1] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032

出　　处：《介入放射学杂志》2009年第11期827-830,共4页Journal of Interventional Radiology

摘　　要：目的报道植入125I籽源条及金属支架联合经动脉化疗栓塞治疗肝癌合并下腔静脉梗阻的初步结果。方法自2009年3-6月,8例肝癌合并下腔静脉梗阻的患者入选本组研究,所有患者均为男性,平均年龄(61±10)岁。在患者下腔静脉梗阻段植入125I籽源条及Z型自膨胀式金属支架,同时实施经动脉化疗栓塞术。分别对患者术前、术后下腔静脉梗阻段直径、右心房与梗阻段远端的压差及临床梗阻相关症状进行比较。术后每月对患者进行随访。结果在下腔静脉梗阻段成功地置入8枚支架、10条125I籽源条,共植入138枚放射性125I籽源。术后患者临床症状改善显著。除1例患者术后2 d出现急性肾功能不全,其余患者无严重并发症。在平均(2.12±0.64)个月的随访期内,1例患者IVC支架发生闭塞,余患者支架保持通畅。结论初步经验表明:植入125I籽源条及金属支架联合经动脉化疗栓塞治疗肝癌合并下腔静脉梗阻安全、可行,其远期疗效有待于进一步的研究。Objective To report the preliminary results of placing metallic stent and 125I seed strand combined with transcatheter arterial chemoembolization（TACE） for the treatment of hepatocellular carcinoma（HCC） with inferior vena cava（IVC） obstruction.Methods From March 2009 to June 2009,implantation of radioactive 125I seed strand and metallic stent combined with TACE treatment was performed in 8 cases of HCC with malignant IVC obstruction.All patients were males with a mean age of（60.6 ± 9.6） years.125I seed strand and Z-type self-expandable metallic stent were placed in the obstructive segment of IVC,which was followed by TACE.Before and after the treatment,the diameter of the obstructive segment of IVC,the pressure gradient between right atrium and distal end of obstructive segment of IVC,and the symptoms related to the obstruction were estimated and recorded,the results were compared individually.Clinical follow-up was conducted in all patients.Results A total of 8 stents and 10 125I seed...更多 strands were placed in the obstructive segment of IVC.Altogether 138 125I seeds were implanted in 8 patients.Obvious clinical improvements were obtained after therapy.No complications occurred in all patients except one patient who experienced acute renal dysfunction at the second day after therapy.During a mean of（2.1 ± 0.6） months follow-up,occlusion of IVC stent was detected in 1 patient.The remaining stents remained patent.Conclusion Our initial results indicate that placement of 125I seed strand and metallic stent combined with TACE is a safe and feasible therapeutic option for advanced HCC with malignant IVC obstruction.

关 键 词：静脉 下腔 梗阻 放射性 125I籽源 支架 肝细胞肝癌 

分 类 号：R735.7[医药卫生—肿瘤]