肝外动脉供血在原发性肝癌介入治疗中的意义  

The significance of blood supply from extrahepatic artery in interventional therapy for primary hepatic cancer

作　　者：钟嘉明[1] 刘丽[1] 陈晓霞[1] 丁宁[1] 翟健[1] 李晓伟[1] 曲增强[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院放射介入二科,上海200438

出　　处：《临床和实验医学杂志》2016年第11期1083-1086,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨原发性肝癌肝外动脉供血情况及其在介入治疗中的意义。方法收集2014年6月1日至2015年1月31日在我院行经导管肝动脉灌注化疗栓塞术（TACE）治疗中发现肝外动脉供血并进行化疗栓塞的129例原发性肝癌患者的临床资料,分析肝外动脉供血情况,并随访观察疗效。结果同期有540例原发性肝癌患者行多次TACE治疗,其中129例患者先后在第1~7次TACE术中发现肝外动脉供血并进行插管化疗栓塞。129例患者中共见158支肝外供血动脉,分别是膈下动脉69支、肠系膜上动脉45支、胃左动脉30支、胃十二指肠12支及右肾上腺动脉2支。首次行肝外供血动脉化疗栓塞后完全缓解7例（13.2%）,部分缓解82例（63.6%）,疾病稳定24例（18.6%）,疾病进展6例（4.7%）,缓解率为76.7%。在多次TACE治疗后肿瘤进展的28例患者中,缓解率为75.0%。随访3~19个月,生存时间1年以上者96例（74.4%）。结论原发性肝癌的肝外血供较为常见和多变,对原发性肝癌肝外供血动脉进行化疗栓塞能有效提高介入治疗的近期疗效。Objective To explore the extrahepatic arterial blood supply of primary hepatic cancer（PHC）and its significance in interven-tional therapy. Methods The clinical data of 129 patients with primary liver cancer undertook routine celiac arterial angiography in order to ex-plore the extrahepatic arterial blood supply for tumor and treated with superselective transcatheter arterial chemoembolism（ TACE）during June 2014 to January 2015 were reviewed,and they were followed - up for their efficacy. The anatomy of these extrahepatic arteries had been discussed and the curative effect had been observed. Results These 540 cases were undertook routine celiac arterial angiography for TACE treatment,158 extrahepatic feeding arteries to PHC in 129 cases were found in 1 to 7 sessions of TACE. The extrahepatic feeding arteries including 69 from inferi-or phrenic artery（IPA）,45 from superior mesenteric arteries（SMA）,30 from left gastric arteries（LGA）,12 from gastroduodenal arteries and 2 from right adrenal arteries. The response rate was 76. 7% after first extrahepatic collateral arterial chemoembolization. Among these patients,com-plete remission had been observed in 17 cases（13. 2% ）,partial remission in 82 cases（63. 6% ）,stableness of disease in 24 cases（18. 6% ） and progress in disease in 6 cases（4. 7% ）. In 28 cases with progress of the disease after repeated TACE,the response rate was 75. 0% after first extrahepatic collateral arterial chemoembolization. During the follow - up period of 3 to 19 months,the survival period longer than 1 year had been seen in 96 patients（74. 4% ）. Conclusion The extrahepatic feeding artery is commonly seen with various changes. The accurate and complete block of arterial blood supply can raise the short - term effect of interventional therapy.

关 键 词：原发性肝癌 肝动脉化疗栓塞 肝外动脉供血 

分 类 号：R735.7[医药卫生—肿瘤]