肝外动脉供血在TACE治疗原发性肝癌临床意义的探讨  

Signifcance of extrahepatic artery on transarterial chemoembolization for hepatocellular carcinoma

作　　者：李金鹏[1,2] 陈华[1,2] 宋金龙[1] 

机构地区：[1]山东省肿瘤医院外九科,山东济南250117 [2]济南大学山东省医学科学院医学与生命科学学院,山东济南250000

出　　处：《中华肿瘤防治杂志》2012年第24期1894-1896,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨肝癌肝外动脉在介入治疗原发性肝癌中的意义。方法:回顾性分析2009-03-2010-08山东省肿瘤医院200例原发性肝癌患者的DSA资料。所有患者行常规腹腔动脉造影及肝外动脉探查,并对其行超选择性插管及化疗栓塞治疗(TACE)。结果:200例患者共接受257次TACE治疗,36例患者存在47条肝外动脉参入肿瘤供血,主要来自膈下动脉(10例),肋间动脉(4例),内乳动脉(1例),网膜动脉(3例),胃十二指肠动脉(8例),肠系膜上动脉的分支(10例)。33例患者肝外动脉均行超选择性插管和化疗栓塞治疗,其余3例患者肝外动脉困未能成功超选择性插管而经皮射频消融治疗后CR。结论:肝外动脉的存在直接影响肝癌治疗的疗效,对肝外动脉供血支超选择性栓塞治疗,对提高TACE的疗效具有十分重要的意义。OBJECTIVE： To investigate the effects of extrahepatic arteries on the interventional treatment of primary he- patic carcinoma. METHODS：The DSA results of 200 patients of primary hepatic carcinoma, treated in our hospital during March 2009 to August 2010, were retrospectively analyzed and evaluated. All patients underwent conventional abdominal angiography and hepatic artery probe, and received superselective catheterization and chemoembolization. RESULTS： Totally 200 patients accepted 275 times TACE treatment,47 extrahepatic arteries,which were involved in the blood supply of liver carcinoma were found in 36 cases. The sources included inferior phrenic artery（10 cases）, intercostal artery（4 cases）, Internal mammary artery（1 case）, retinal artery（3 cases）,gastroduodenal artery （8 cases）, branch of superior mesenteric artery（ 10 cases）. Successful chemoembolization through these collaterals was achieved in 33 cases and complete response was noted on follow-up. In the remaining 3 cases, chemo- embolization could not be done and RFA was performed subsequently and CR. CONCLUSION： The presence of extrahepatic arter- ies affect the effectiveness of clinical treatment of hepatic carcinoma,The identification and TACE treatment of extrahepatic arter- ies can be help to improve the efficacy of interventional therapy.

关 键 词：肝肿瘤 外科学 肝动脉 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤]