肝细胞肝癌TACE术后碘油肺栓塞的危险因素分析  

Risk factors of pulmonary lipiodol embolism after TACE for hepatocellular carcinoma

作　　者：陈水兵[1] 虞希祥[2] CHEN Shui-bing;YU Xi-xiang(Department of Interventional Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China;Department of Interventional Radiology & Vascular Surgery, The Third Clinical Institute Affiliated to Wenzhou Medical University,Wenzhou, Zhejiang 325000, China)

机构地区：[1]温州医科大学附属第二医院/育英儿童医院介入科,浙江温州325000 [2]温州医科大学温州市第三临床学院介入血管外科,浙江温州325000

出　　处：《肝胆胰外科杂志》2017年第4期276-280,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨肝细胞肝癌TACE术后发生碘油肺栓塞的相关危险因素。方法回顾性分析2011年1月至2016年12月温州医科大学附属第二医院育英儿童医院诊断肝细胞肝癌并行TACE术的310例病例资料,对18个可能与肝细胞肝癌TACE术后碘油肺栓塞相关的因素进行单因素分析。对单因素分析有统计学意义的因素,采用非条件二元多因素Logistic回归分析其与肝细胞肝癌TACE术后碘油肺栓塞的相关性。结果310例中27例发生肝细胞肝癌TACE术后碘油肺栓塞,发生率为8.71%。单因素分析显示:最大肿瘤直径≥10 cm、碘油使用量≥15 mL、肝动-静脉瘘、肝癌破裂、未经治疗的下腔静脉癌栓是肝细胞肝癌TACE术后发生碘油肺栓塞的危险因素(P<0.05)。多因素Logistic回归分析显示:最大肿瘤直径≥10 cm、碘油使用量≥15 mL、肝动-静脉瘘、肝癌破裂是肝细胞肝癌TACE术后发生碘油肺栓塞的独立危险因素(P<0.05)。结论肝细胞肝癌TACE术后碘油肺栓塞的发生率并不低,针对相关危险因素采取适当措施有助于减少肝细胞肝癌TACE术后碘油肺栓塞的发生。Objective To explore the related risk factors of pulmonary lipiodol embolism(PLE)after transhepaticarterial chemoembolization(TACE)on hepatocellular carcinoma(HCC).Methods A retrospectiveanalysis was conducted on310HCC patients who underwent TACE in the Second Affiliated Hospital and YuyingChildren’s Hospital of Wenzhou Medical University between Jan.2011and Dec.2016.Univariate analysis wascarried out on the18possibly-related factors to PLE after TACE for HCC.For the factors that were statisticallydifferent in the univariate analysis,their correlation with PLE was explored by non-conditional binary multipleLogistic regression analysis.Results Among the310cases,27cases suffered PLE after TACE,with the incidenceof PLE8.71%.Univariate analysis showed that the maximum tumor diameter≥10cm,the volume of lipiodol≥15mL,hepatic arteriovenous fistula,rupture of HCC,untreated tumor thrombus in the inferior vena cavawere the risk factors of PLE(P<0.05).Multiple Logistic regression analysis showed that the maximum tumordiameter≥10cm,the volume of lipiodol≥15mL,hepatic arteriovenous fistula,rupture of HCC were the independentrisk factors of PLE(P<0.05).Conclusion The incidence of PLE after TACE for HCC could be high.Totake appropriate measures in view of the related risk factors can help to reduce the occurrence of PLE after TACEfor HCC.

关 键 词：肝细胞肝癌 肝动脉化疗栓塞术 碘油 肺栓塞 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]