经导管载药微球栓塞术治疗晚期膀胱癌伴出血患者的临床研究  

Clinical study of transcatheter drug-loaded microsphere embolization in the treatment of patients with advanced bladder cancer with bleeding

作　　者：陈启鸿 张庆贤 林剑雄 黄金旗 高晓杰 CHEN Qihong;ZHANG Qingxian;LIN Jianxiong;HUANG Jinqi;GAO Xiaojie(Department of Interventional Vascular Surgery,the First Hospital of Putian City,Putian,Fujian Province 351100,China)

机构地区：[1]莆田市第一医院介入血管外科,福建莆田351100

出　　处：《实用放射学杂志》2024年第10期1699-1701,1716,共4页Journal of Practical Radiology

摘　　要：目的探讨经导管载药微球栓塞术(DLME)治疗晚期膀胱癌伴出血(ABCB)患者的可行性、安全性和有效性。方法回顾性选取接受肿瘤供血动脉DLME治疗的ABCB患者26例。观察术后疗效及相关并发症,术后随访血尿复发及生存情况。结果26例手术均取得成功,技术成功率100.0%。双侧膀胱动脉栓塞21例(80.8%),单侧栓塞5例(19.2%)。术后3 d,24例(92.3%)血尿缓解,余2例(7.7%)血尿未缓解,再次行介入治疗后缓解。与术前相比,术后1周输血率、输血量、红细胞比积和血红蛋白均明显改善(P<0.05)。末次介入术后1个月,完全缓解2例、部分缓解19例、疾病稳定3例、疾病进展2例,客观缓解率为80.8%,疾病控制率为92.3%。与术前比较,术后1个月T分期明显改善(P<0.05)。无患者出现异位栓塞等严重并发症。术后随访3~36个月,5例(19.2%)血尿复发。结论经导管DLME治疗ABCB患者是可行、安全、有效的,是一种可选择的微创姑息性措施。Objective To investigate the feasibility,safety and efficacy of transcatheter drug-loaded microsphere embolization(DLME)in treating patients with advanced bladder cancer with bleeding(ABCB).Methods A total of 26 ABCB patients who underwent DLME for tumor supply arteries were retrospectively selected.The postoperative efficacy and related complications were observed.The recurrence of hematuria and survival situation were followed up.Results All 26 surgeries achieved success with a technical success rate of 100.0%.There were 21 cases(80.8%)of bilateral bladder artery embolism and 5 cases(19.2%)of unilateral bladder artery embolism.Three days after the operation,24 patients(92.3%)had hematuria remission.And the other two patients(7.7%)had no hematuria remission,they were relieved after interventional embolization again.Compared with that before operation,the blood transfusion rate,blood transfusion volume,hematocrit and hemoglobin at one week after operation were significantly improved(P<0.05).One month after the last intervention,there were 2 cases of complete response,19 cases of partial response,3 cases of stable disease,and 2 cases of progressive disease.The objective remission rate was 80.8%,and the disease control rate was 92.3%.Compared with that before operation,the T stage was significantly improved at one month after operation(P<0.05).No patients had severe complications such as ectopic embolism.After follow-up for 3-36 months,5 cases(19.2%)had a recurrence of hematuria.Conclusion Transcatheter DLME is feasible,safe,and effective in the treatment of patients with ABCB.It is an optional,minimally invasive palliative measure.

关 键 词：经导管载药微球栓塞术 膀胱癌 出血 

分 类 号：R815[医药卫生—放射医学] R737.14[医药卫生—临床医学]