明胶海绵加碘油在肝动门脉瘘介入治疗中的临床观察  

Interventional therapy of hepatic artery-portal vein fistula with gelatin sponge and lipiodol

作　　者：徐海峰[1] 杨仁杰[1] 陈辉[1] 朱旭[1] 

机构地区：[1]100142,北京大学临床肿瘤学院,北京肿瘤医院,北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中华医学杂志》2011年第15期1061-1063,共3页National Medical Journal of China

基　　金：国家传染病防治科技重大专项（2008ZXl0002-26）;中华国际医学交流基金（医基发2008-17）

摘　　要：目的 比较分别用单纯明胶海绵及明胶海绵加碘油对肝动门脉瘘进行栓塞后的血管再通率.方法 回顾分析北京肿瘤医院51例肝脏恶性肿瘤合并有肝动门脉瘘患者的临床资料,根据栓塞手段不同分为单纯明胶海绵栓塞（A组）及明胶海绵加碘油栓塞（B组）两组,比较其30～40 d及60～70 d肝动门脉瘘血管再通率.结果 两组患者的平均年龄、性别、病理类型及术前肝功能分级两组差异无统计学意义.A组26例患者28处肝动门脉瘘,1处未栓塞成功,B组25例患者26处肝动门脉瘘均栓塞成功.30～40 d时A组、B组肝动门脉瘘血管再通率分别为70.37%及42.3%,经卡方检验x2=4.25,P=0.039;60～70 d时A组、B组肝动门脉瘘血管再通率分别为92.59%及88.46%,经精确概率检验P=0.67.结论 明胶海绵加碘油封堵肝动门脉瘘是安全的,短期内可以降低血管再通率,在临床工作中可采用,从而为控制肝内恶性肿瘤争取时间.Objective To observe and compare the revasculation rate after embolization of hepatic artery-portal vein fistula （APVF） by gelatin sponge versus gelatin sponge with lipiodol. Methods The clinical data of 51 patients were retrospectively analyzed. They were divided into Groups A and B. APVF was embolized by gelatin sponge alone in Group A and gelatin sponge with lipiodol in Group B. Then the investigators observed and compared the revasculation rate of hepatic artery-portal vein fistula at Days 30 - 40and 60- 70 post-embolization respectively. Results There was no statistical difference in age, gender,pathological types and hepatic functions before intervention between Groups A and B. One of 28 APVF sites was embolized unsuccessfully in Group A while all APVF cases were embolized successfully in Group B. The revasculation rate of hepatic APVF were 70. 37% and 46. 15% at Days 30 -40 post-embolization in Groups A and B respectively （x2 = 4. 25, P = 0. 039, chi-square test）; the revasculation rates of APVF were 92. 59% and 88.46% respectively at Days 60 - 70 post-embolization （ P = 0. 67）. Conclusion Interventional therapy of hepatic APVF by gelatin sponge and lipiodol is a safe method of reducing the short-term revasculation rate. It may be employed in clinical practices to save precious time for controlling hepatic malignant tumors.

关 键 词：肝肿瘤 明胶海绵 吸收性 碘油 动门脉瘘 

分 类 号：R735.7[医药卫生—肿瘤]