胸廓内动脉参与肝癌供血介入栓塞后皮肤损伤的发生及预防  

Skin injury after embolization of ITA participating in blood supply of liver cancer

作　　者：宋鹏[1] 吴宁[1] 林福煌[1] 李斯锐[1] 陈峰[1] 

机构地区：[1]海南省人民医院放射介入科,海口570311

出　　处：《中华介入放射学电子杂志》2015年第3期140-143,共4页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的探讨胸廓内动脉（ITA）参与肝癌供血行介入栓塞治疗后皮肤损伤的发生特点及预防措施.方法对26例经血管造影确认有ITA参与肝癌供血者行ITA栓塞治疗.26例患者既往行TACE治疗2-6次,5例有肝切除病史.其中16例用碘油-抗癌药物乳剂栓塞,10例用碘化油及明胶海绵颗粒进行栓塞.8例用微导管行超选择性肿瘤供血动脉栓塞.术后观察并随访患者前胸壁及肝区皮肤变化.结果26例患者ITA参与肝癌供血者,右侧ITA24例,左侧ITA3例.19例介入治疗后出现不同程度前胸壁及肝区皮肤灼热感或针刺样疼痛.5例出现明显皮肤损伤,其中3例损伤皮肤出现破溃,1例继发感染.5例患者均应用碘油-抗癌药物乳剂行非选择性ITA栓塞.随诊1-4个月后5例均结痴愈合.结论皮肤损伤是经导管介入栓塞ITA的常见并发症,应用碘油-抗癌药物乳剂非选择性栓塞ITA是造成皮肤损伤的主要原因.Objective To explore the characteristics and the preventive measures o f skin injury after interventional embolization of internal thoracic artery （ITA） participating in the blood supply of liver cancer. Methods ITA embolization was perfomied in 26 hepatic carcinoma patients confirmed to be the tumor blood supply arteries by angiography. All of the 26 patients had received TACE treatment for 2 to 6 times, and 5 of them had received liver resection, A total of 16 patients received ITA embolization by lipiodol antineoplastic emulsion, but lipiodol and Gelfoam were used in the other 10 patients. Eight cases received super selective embolization with microcatheter. Observe and follow-iq） the change of the anterior chest wall skin. Results Twenty-four of the 26 patients received RITA embolization, 3 received LITA embolization, and 1 patient received both RITA and LITA embolization. Afler interventional therapy, 19 patients experienced different degree of burning sense and stabbing pain in the skin of anterior chest wall and liver area. Obvious skin injuiy occurred in 5 cases, and 3 of them appeared damaged skin rupture, and 1 case got secondary infection. All of the 5 patients got non-selective ITA embolization with lipiodol antineoplastic emulsion, and they all healed in 1-4 months. Conclusions Non-selective ITA embolization with lipiodol antineoplastic emulsion is the main cause of the skin damage.

关 键 词：皮肤损伤 肝肿瘤 胸廓内动脉 动脉造影 栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]