肝血管瘤血供类型对经肝动脉介入治疗效果的影响  

The relationship between the type of blood supply and the efficacy of transcatheter arterial interventional therapy for hepatic hemangioma

作　　者：姚煜 戴峰[1] 徐春阳 YAO Yu;DAI Feng;XU Chun-yang(Second Hospitals of of Nanjing,Jiangsu 210000,China)

机构地区：[1]南京市第二医院肝脏肿瘤治疗中心,210000

出　　处：《肝脏》2020年第6期591-594,共4页Chinese Hepatology

基　　金：江苏省自然科学基金资助项目(BK20160104)。

摘　　要：目的探讨肝血管瘤血供类型对经肝动脉介入治疗效果的影响。方法选取南京市第二医院2017年1月至2019年1月收治的肝血管瘤患者128例,根据患者的血供情况分成3组,分别为富血供组(43例)、中等血供组(47例)、乏血供组(38例)。所有患者均经肝动脉栓塞介入治疗。分别在术后3、6个月评估临床疗效,并记录术后6个月的瘤体缩小率、动脉期强化比率缩小率。比较3组术前及术后3 d、7 d、14 d的肝功能指标,包括丙氨酸氨基转移酶(ALT)、直接胆红素(DBil)、总胆红素(TBil)水平,分析并发症情况。结果富血供组、中等血供组术后3个月的总缓解率分别为76.74%、72.34%,均显著高于乏血供组的47.37%(P<0.05)。富血供组、中等血供组术后6个月的总缓解率分别为72.09%、63.83%,均显著高于乏血供组的39.47%(P<0.05)。富血供组、中等血供组的瘤体缩小率分别为(55.62±10.05)%、(50.34±8.51)%,均显著高于乏血供组的(31.28±8.32)%(P<0.05)。富血供组、中等血供组的动脉期强化比率缩小率分别为(28.53±5.12)%、(23.64±4.87)%,均显著高于乏血供组的(17.29±5.23)%(P<0.05)。3组术后3 d、7 d的血清ALT、DBil、TBil水平均高于术前(P<0.05)。3组并发症率比较差异无统计学意义(P>0.05)。结论与乏血供者相比,富血供、中等血供者经肝动脉栓塞介入术后3、6个月的疗效更好,且瘤体缩小率与动脉期强化比率缩小率高于乏血供患者,但不同血供类型患者的肝功能、并发症未见明显差异。Objective To investigate the relationship between the type of blood supply and the efficacy of transcatheter arterial interventional therapy for hepatic hemangioma.Methods 128 patients with hepatic hemangioma admitted to our hospital from January 2017 to January 2019 were divided into three groups according to their blood supply.They were rich blood supply group(case number=43),medium blood supply group(case number=47),and deficient blood supply group(case number=38).All patients underwent interventional therapy via hepatic artery embolization.The clinical effects of three groups were evaluated at 3 and 6 months after operation,and the reduction rates of tumors and arterial phase enhancement were recorded at 6 months after operation.The liver function indexes,including alanine aminotransferase(AAT),direct bilirubin(DB)and total bilirubin(TB),were compared before and 3,7 and 14 days after operation in three groups,and the complications were analyzed.Results The total remission rates of the rich blood supply group and the medium blood supply group were[76.74%and 72.34%]respectively,which were significantly higher than those of the hypovascular group[47.37%(P<0.05)].The total remission rates of the blood supply group and the medium blood supply group were[72.09%and 63.83%]respectively,which were significantly higher than those of the hypovascular group[(39.47%(P<0.05)].The tumor shrinkage rates of the rich blood supply group and the medium blood supply group were[(55.62±10.05)%,(50.34±8.51)%],which were significantly higher than those of the poor blood supply group[(31.28±8.32)%(P<0.05)].The reduction rates of arterial phase enhancement in the rich blood supply group and the medium blood supply group were[(28.53±5.12)%,(23.64±4.87)%],which were significantly higher than those in the poor blood supply group[(17.29±5.23)%(P<0.05)].The serum levels of AAT,DBil and TBil at 3 and 7 days after operation in the three groups were higher than those before operation(P<0.05).The incidence of fever,nausea,vomiting,cholecy

关 键 词：肝血管瘤 肝动脉栓塞介入术 瘤体缩小率 肝功能 并发症 

分 类 号：R735.7[医药卫生—肿瘤]