Embosphere微粒球经导管栓塞治疗腹盆部肿瘤的疗效及安全性  

Clinical Efficacy and Safety of Embosphere in Treatment of Hypervascular Tumor

作　　者：李立恒[1] 肖承江[1] 黎超[1] 韦文姜[1] 江桂华[1] 

机构地区：[1]广东省第二人民医院,广东广州510317

出　　处：《现代医院》2016年第8期1129-1132,共4页Modern Hospitals

基　　金：广东省医学科研基金(编号:A2015205)

摘　　要：目的观察Embosphere微粒球经动脉途径栓塞治疗腹盆腔良恶性肿瘤的疗效和安全性。方法回顾性分析2015年9月-2016年4月共64例腹盆部肿瘤患者,其中原发性肝脏肿瘤31例,消化道肿瘤13例,子宫附件肿瘤16例,腹膜后肿瘤4例,肿瘤伴发出血20例,全部患者均采用经导管灌注Embosphere微粒球的方法栓塞肿瘤血管,术中通过数字减影血管造影检查评估栓塞前及栓塞后目标肿瘤的供血情况,通过CT/MR增强扫描对比观察目标瘤灶术后1个月体积变化及血供情况,评估目标瘤灶的临床疗效,临床观察患者术后有无异位栓塞并发症和不良反应。结果患者术后1个月复查CT/MR提示目标瘤灶体积较术前均明显缩小,差异有统计学意义(P<0.05),临床有效率100%(64/64),肿瘤并出血患者首次介入栓塞后出血停止19例,栓塞后再次出血1例,表现为反复便血,复发原因为肿瘤存在多支供血动脉,再次栓塞成功止血;出现异位栓塞1例,并发症率1.6%(1/64),不良反应主要为疼痛、发热,经止痛、退热对症处理后症状均可缓解。结论 Embosphere微粒球经动脉栓塞治疗腹盆部肿瘤近期疗效显著,中远期疗效有待进一步观察,超选择性肿瘤血管栓塞是减少异位栓塞严重并发症的有效方法,值得临床推广应用。Objective Objective To investigate the efficacy and safety of Embosphere in the treatment of abdominal and pelvic tumor. Methods From September 2015 to April 2016,we recruited 64 patients with abdominal and pelvic tumor,including 31 cases of primary hepatic tumor,13 cases of digestive tract cancer,16 cases of uterine accessory tumor,20 cases of tumor with hemorrhage. All patients were treated with transcatheter Embosphere embolization of tumor blood vessels. Intraoperative digital subtraction angiography was used to evaluate the blood supply of the target tumor before and after embolization. CT and MRI were used to observe the changes of volume and blood supply of the tumor after operation one months later,to evaluate the clinical efficacy,and to clinically observe whether patients have postoperative complications resulted from abnormal embolization and adverse reactions. Results The tumor volume was significantly reduced when compared with that before operation（ P〈0. 05）,with 100% of clinical efficacy rate（ 64 /64）. Nineteen patients with tumor hemorrhage stop bleeding for the first time after embolization. Although one patients with recurrence of bleeding representing as recurrent hemoptysis after embolization due to existence of multiple feeding arteries,bleeding stopped successfully after embolism again. Ectopic embolism occurred in 1 cases（ 1 /64）. The main adverse reaction was pain and fever,but symptomatic treatment can alleviate the symptoms. Conclusion The recent therapeutic effect of Embosphere particle embolization in the treatment of abdominal and pelvic tumor is favorible,despite the mid- and long- term efficacy needs to be further investigate. Super selective embolization is worthy of clinical application thanks to that it can reduce the serious complications of ectopic embolism.

关 键 词：Embosphere 栓塞 腹盆部 肿瘤 

分 类 号：R730.59[医药卫生—肿瘤]