动脉栓塞术治疗肝血管瘤的远期疗效评价  

Transcatheter arterial embolization for the treatment of hepatic hemangioma: a retrospective evaluation of long term efficacy

作　　者：李书书 何仕诚[2] 方文[2] 朱海东[2] 郭金和[2] 朱光宇[2] 邓钢[2] 杜瑞杰[2] LI Shu-shu;HE Shi-cheng;FANG Wen;ZHU Hai-dong;GUO Jin-he;ZHU Guang-yu;DENG Gang;Du Rui-jie(Department of Radiology,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学医学院医学影像系,江苏南京210009 [2]东南大学附属中大医院介入与血管外科,江苏南京210009

出　　处：《现代医学》2018年第8期881-886,共6页Modern Medical Journal

摘　　要：目的:评价动脉栓塞术(TAE)治疗肝血管瘤的远期疗效及术后瘤体大小变化规律。方法:回顾性分析2005年1月至2017年1月治疗的肝血管瘤137例155个瘤体,采用碘化油与平阳霉素混合乳剂及明胶海绵颗粒栓塞瘤体供血动脉,术后定期复查CT评价瘤体大小并计算平均缩小率,比较1个月内肝肾功能变化。结果:所有瘤体均栓塞成功。TAE后随访时间点6个月、6月～1年、1～3年、3～5年及5～12年CT测量瘤体平均缩小率分别为61. 6%、72. 2%、83. 9%、88. 3%及89. 9%,其中TAE后3年内3个随访点瘤体呈逐步缩小,均有显著性差异(P <0. 05),余随访点无显著性差异(P> 0. 05)。TAE后1周AST及ALT较术前均有显著性差异(P <0. 05),但ALB、Tbil、Dbil、Bun、Cr较术前均无显著差异(P> 0. 05); TAE后1个月AST及ALT较术前均无显著差异(P> 0. 05)。无严重并发症发生。结论:TAE治疗肝血管瘤安全、远期疗效显著;术后1年内瘤体进行性缩小,1～12年期间瘤体缩小趋于稳定。Objective： To evaluate the long-term efficacy and tumor shrinkage after transcatheter arterial embolization（ TAE） of hepatic hemangioma（ HH）. Methods： A total of 137 HH patients with 155 lesions were retrospectively analyzed in our institution from January 2005 to January 2017. TAE was carried out using Pingyang mycin-lipiodol emulsion and gelfoam particles. The efficacy was assessed by the change of the size of tumor on CT after treatment during followed-up. The liver and renal function before TAE,1 week and 1 month after TAE was compared. Results： The successful rate of TAE was 100%. The average reduction rate of 6 months,6 months to 1 years,1 to 3 years,3 to 5 years and 5 to 12 years were 61. 6%,72. 2%,83. 9%,88. 3% and 89. 9% respectively,there were significant differences of reduced averaged tumor size at three follow-up points in 3 years after TAE and no significant differences beyond 3 years after TAE. There were significant differences of AST and ALT one week after TAE compared to preprocedure,moreover,AST and ALT averagely increased by 52. 8 U·L^-1 and 57. 7 U·L^-1 respectively,however,ALB,Tbil,Dbil,Bun and Cr were not significantly different from those before operation. 1 months after TAE,there were no significant differences in AST,ALT,ALB,Tbil,Dbil,Bun and Cr compared with those before operation. Conclusion： TAE is safe and effective in the treatment of HH and the longterm effect is significant. After embolization,the size of the tumor gradually reduces in one year after TAE,and then tends to be stable after in 12 years.

关 键 词：肝血管瘤 平阳霉素碘化油乳剂 动脉栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]