肝动脉介入术后胆囊炎发生相关因素分析及防治探讨  

Analysis on Related Factors and Prevention of Cholecystitis After Transcatheter Hepatic Artery Embolization

作　　者：陈光斌[1] 胡洁[2] 李江山[1] 

机构地区：[1]湖北医药学院附属人民医院介入科,十堰442000 [2]湖北医药学院附属人民医院放射科,十堰442000

出　　处：《临床放射学杂志》2013年第11期1637-1640,共4页Journal of Clinical Radiology

摘　　要：目的探讨肝动脉介入治疗肝良恶性肿瘤与胆囊炎发生相关因素及防治措施。方法回顾性分析53例胆囊动脉栓塞病例,将患者胆囊炎史、肝脏手术史、栓塞前造影胆囊壁显影、栓塞后胆囊壁碘油沉积、病灶大小、肝脏肿瘤类型等因素与术后胆囊炎的发生进行相关性分析,对术后胆囊炎发生病例密切观察及进行禁食、抗炎及解痉镇痛等治疗。结果术后发生胆囊炎15例(28.3%),14例经及时对症支持治疗后症状缓解,1例未及时处理发生胆囊坏死而行胆囊切除。肝动脉介入术后胆囊炎发生与栓塞前胆囊壁显影及栓塞后胆囊壁碘油沉积密切相关(χ2=16.915,P<0.05;χ2=19.124,P<0.05)。结论肝动脉造影中发现胆囊壁显影应采用超选择插管技术以避开胆囊动脉,对栓塞后出现胆囊壁碘油沉积应及时行对症支持治疗,避免胆囊坏死、穿孔等严重并发症发生。Objective To investigate the related factors and prevention of cholecystitis after hepatic artery interventional treatment of benign and malignant liver tumors. Methods The clinical data of 53 patients with liver tumors received tran scatheter hepatic artery embolization and occurrence of cystic artery embolism were analyzed retrospectively. The factors of cholecystitis history,liver surgery history, the conditions of the gallbladder wall developing before embolization, the condi tions of the gallbladder wall with lipiodol deposition after embolization, lesion size, type of liver tumors related to the occur rence of cholecystitis after embolization were analyzed. All cholecystitis occurred after the embolization were observed closely and treated with fasting, antiinflammatory, antispasmodic, relieve pain. Results Cholecystitis was occurred in 15 cases （28.3%） Among 15 cases, the symptom of cholecystitis relieved in 14 cases with timely symptomatic treatment, 1 case without timely symptomatic treatment received surgical resection because of gallbladder necrosis occurrence. After tran scatheter hepatic artery embolization, the cholecystitis occurrence was closely related to the gallbladder wall developing be fore embolization and the gallbladder wall deposition with lipiodol after embolization （ x2 = 16.915, P 〈 0.05, x2 = 19.124, P 〈 0.05）. Conclusion Superselective catheterizing technique should be taken to avoid cystic artery when gallbladder wall is developing on the arteriogram, symptomatic and supportive treatment should be taken timely to avoid serious complications of gallbladder necrosis or perforation.

关 键 词：肝肿瘤 动脉栓塞 胆囊炎 

分 类 号：R575.6[医药卫生—消化系统]