膈下动脉参与肝脏肿瘤供血的影像与介入治疗效果  

Subphrenic Artery is Involved in the Imaging and Interventional Effect of Blood Supply to Liver Tumors

作　　者：游琴章 吴伟宝 郭彬 YOU Qinzhang;WU Weibao;GUO Bin(Department of Intervention,the Second Hospital of Longyan,Fujian Province,Longyan Fujian 364000,China)

机构地区：[1]福建省龙岩市第二医院介入科,福建龙岩364000

出　　处：《中国卫生标准管理》2024年第7期126-129,共4页China Health Standard Management

摘　　要：目的研究膈下动脉参与肝脏肿瘤供血影像学表现以及介入治疗的效果、安全性。方法选择2020年1月—2022年12月在福建省龙岩市第二医院接受血管造影检查,被确诊为肝脏肿瘤的患者80例为研究对象,对肿瘤供血的膈下动脉分支实施栓塞治疗,其中74例患者采用5F Cobra型导管,另外6例实施同轴微导管。随后将患者治疗后的并发症发生率、肿瘤位置分布情况、治疗前后甲胎蛋白(alpha fetoprotein,AFP)水平以及治疗成功率进行分析。结果入组的80例患者中,有6例患者(7.50%)肿瘤位于肝脏深部,其他74例患者(92.50%)肿瘤接近或已经累及到肝表面。80例患者中,均表现为右隔下动脉参与肝肿瘤供血,其临床特征以主干显著增粗为主;共有6例患者发生了膈肌痉挛,其并发症发生率为7.5%,且该并发症于30 min后自行缓解。其中1例患者发生了顽固性呃逆,3 d后自行消退,占1.25%。80例患者均栓塞成功,其中54例一次性成功,另外26例二次膈下动脉栓塞成功;此外,治疗后,患者的AFP水平显著低于治疗前(P<0.05)。结论本研究开展了膈下动脉介入肝脏肿瘤的血管造影研究,取得了较好的疗效,尤其是在靠近肝被膜或横膈膜的部位,采用右侧膈下动脉为其提供血液,实现了高效率的化学栓塞,但同时也要注意难治性呃逆及膈肌痉挛等并发症,其疗效明显。Objective To study the imaging manifestations of subphrenic artery involved in liver tumor blood supply and the efficacy and safety of interventional therapy.Methods A total of 80 patients who underwent angiography in the Second Hospital of Longyan,Fujian Province from January 2020 to December 2022 were diagnosed with liver tumors and were selected to embolize the subphrenic artery branches supplied by the tumors,of which 74 patients were treated with 5F Cobra-type catheters and 6 patients were treated with coaxial microcatheters.Then,the complication rate,tumor location distribution,alpha fetoprotein(AFP)level and treatment success rate before and after treatment were analyzed.Results Of the 80 patients enrolled,6 patients(7.50%)had tumors located deep in the liver,and the other 74 patients(92.50%)had tumors close to or had reached the surface of the liver.Among the 80 patients,all showed that the right subseptal artery was involved in the blood supply of liver tumors,and its clinical features were mainly significantly thickened trunk.A total of 6 patients developed diaphragmatic spasm,which accounted for a complication rate of 7.5%,and the complication resolved spontaneously after 30 minutes.One of the patients developed intractable hiccups,which resolved spontaneously after 3 days,accounting for 1.25%.All 80 patients had successful embolization,of which 54 were successful at one time and 26 had successful secondary subdiaphrenic artery embolization.In addition,after treatment,the AFP level of patients was significantly lower than before treatment(P<0.05).Conclusion Angiography for patients with subphrenic artery involvement in liver tumors has achieved good results,for tumors located in the upper part of the liver,close to the liver capsule or diaphragm,the right subdiaphragmatic artery can be used for efficient chemoembolization,but during the treatment,it is necessary to effectively control complications such as refractory hiccups and diaphragmatic spasm,and the effect is significant.

关 键 词：肝脏肿瘤 膈下动脉 螺旋CT 影像分析 介入治疗 临床疗效 

分 类 号：R735[医药卫生—肿瘤]