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作 者:中国抗癌协会肿瘤介入学专业委员会 中国抗癌协会肿瘤介入学专业委员会化疗与免疫治疗分委会 王晓东 杨仁杰 邹英华[3] 郑廉炼 Professional Commiee of Oncology Intervention,China Anti-Cancer Association;Sub-commitee of Chemotherapy and Immunotherapy,Professional Commitee of Oncology Intervention,ChinaAnti-CancerAssociation;WANG Xiaodong;YANG Renjie;ZOU Yinghua
机构地区:[1]不详 [2]北京大学肿瘤医院 [3]北京大学第一医院
出 处:《介入放射学杂志》2022年第7期633-641,共9页Journal of Interventional Radiology
基 金:北京市医管局“扬帆”计划重点医学专业项目(ZYLX202117);国家自然科学基金(82172039)。
摘 要:近年来,肝动脉灌注化疗(HAIC)作为介入治疗技术之一,应用于治疗进展期肝胆恶性肿瘤的效果逐渐受到认可。但不同临床中心的HAIC操作技术差别较大,缺乏行业规范,且多数以一次性穿刺留管形式完成。为了满足HAIC需长时间持续灌注、多次反复给药的特点,经皮肝动脉化疗药盒系统比一次性穿刺留管更具优势。改良式经皮肝动脉化疗药盒系统植入术采用管头固定技术、肝内外血流再分布术,具有创伤小、导管移位率低、实现全肝灌注、患者舒适性高、并发症少等优点,已在国内外多个临床中心得以证实。为了更好地规范HAIC治疗技术,通过回顾文献并经临床实践和充分讨论,参与本共识编写专家达成改良式经皮肝动脉化疗药盒植入术标准化操作流程、技术要点、HAIC方案、术后并发症防治、药盒系统维护及相关护理常规等共识。In recent years, hepatic arterial infusion chemotherapy(HAIC), as one of the interventional therapeutic techniques, has been gradually recognized in the treatment of advanced hepatobiliary malignancies. However, HAIC operation technique has no unified standard and varies widely in different clinical centers. Usually, in most clinical centers HAIC is performed in a way of pure puncture plus catheter implantation. In order to meet the requirements of long and continuous arterial infusion and repeated drug administration in HAIC treatment, the use of modified percutaneous hepatic arterial port-catheter system is superior to conventional repeated femoral arterial puncture and catheterization. In the implantation of hepatic arterial port-catheter system, the modified fixed-catheter-tip technique and the intra-hepatic and extra-hepatic arterial blood flow redistribution technique are adopted, these techniques have the advantages of small trauma, low catheter displacement rate, achieving the purpose of whole liver perfusion, higher patient comfort, fewer complications, etc., which have already been demonstrated in many clinical centers at home and abroad. In order to better standardize the treatment technique of HAIC, the experts who participate in compiling this consensus, through reviewing the literature, combining own clinical practice experience and making full discussion, have reached following agreements concerning the standardized operation process,technical key points, HAIC regimen, prevention and treatment of postoperative complications, maintenance of port-catheter system and related nursing routines.(J Intervent Radiol, 2022, 31: 633-641)
关 键 词:改良式经皮肝动脉化疗药盒植入术 肝动脉灌注化疗 肝胆系统恶性肿瘤 专家共识
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