网膜分支供血肝细胞癌经导管动脉化疗栓塞术治疗45例  

Transcatheter arterial chemoembolization of hepatocellular carcinoma with blood supply from omental branches:a report of 45 cases

作　　者：韩强[1,2] 朱红玲[2] 田杰 亓小虎[2] HAN Qiang;ZHU Hongling;TIAN Jie;QI Xiaohu(the First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Department of Interventional Radiology,Yichang Central People's Hospital,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院,湖北宜昌443003 [2]宜昌市中心人民医院介入放射科,湖北宜昌443003

出　　处：《实用放射学杂志》2019年第11期1821-1824,共4页Journal of Practical Radiology

摘　　要：目的评价网膜分支供血肝细胞癌(HCC)行经导管动脉化疗栓塞术(TACE)治疗的技术成功率、有效性和安全性.方法回顾性分析45例存在网膜分支供血并行TACE治疗的HCC患者.结果几乎所有患者在发现网膜分支供血前都曾进行过包括TACE在内的多种治疗,其中8例有HCC外科切除史.45例患者共有48个肿瘤,造影发现52支网膜分支参与供血,其中48支(92%)被成功栓塞.37例(82%)患者可以观察到肝动脉的狭窄或闭塞.术后4~6周复查,甲胎蛋白(AFP)水平由术前的5.05~4246.89 ng/mL(平均1748.52 ng/mL)降至3.78~1048.32 ng/mL(平均287.46 ng/mL).32例患者肿瘤明显缩小.13例(29%)肿瘤稳定,但术后2~6个月(平均3个月)复发.28例经网膜分支TACE术后6~18个月(平均10个月)死亡.17例术后存活3~32个月(平均14个月),但是其中8例有肿瘤复发.所有患者没有严重并发症出现.结论经网膜分支行TACE治疗是安全有效的,技术成功率高,要注意同时栓塞所有滋养动脉才能降低复发率.Objective To evaluate the technical success rate,effectiveness and safety of transcatheter arterial chemoembolization(TACE)via the omental branch in the treatment of hepatocellular carcinoma(HCC)with blood supply from the omental branch.Methods 45 patients with HCC fed by the omental branch who had undergone TACE were evaluated retrospectively.Results All patients had undergone several therapeutic procedures including TACE before the revelation of the blood supply from the omental branch,8 patients had a history of surgery of hepatic resection for HCC.45 patients had 48 tumors total,52 omental branches were observed angiographically,48 omental branches(92%)were successfully embolized.Stenosis or occlusion of the hepatic artery was observed in 37 patients(82%).The alpha fetoprotein(AFP)levels were reduced from 5.05-4246.89 ng/mL(mean,1748.52 ng/mL)before treatment to 3.78-1048.32 ng/mL(mean,287.46 ng/mL)after TACE 4-6 weeks later.The tumors diminished in size in 32 patients,stabilized in 13 patients(29%),however,recurred 2-6 months(mean,3 months)after TACE.28 patients died after 6-18 months(mean,10 months),17 patients were alive for 3-32 months(mean,14 months),but tumor recurred in 8 patients.Severe complications were not observed in any patient.Conclusion TACE via the omental branch is safe,effective and had high technical success rate,it is important to embolize all the feeding arteries at the same time for reducing the recurrence rate.

关 键 词：网膜分支 经导管动脉化疗栓塞术 肝细胞癌 肝外侧支动脉 

分 类 号：R815[医药卫生—放射医学] R735.7[医药卫生—临床医学]