经皮局部隔离肝脏灌注化疗合并血液灌流方法学实验研究  

Methodological Experimental Study on Percutaneous Regional IsolatedHepatic Perfusion Combined with Charcoal Hemoperfusion

作　　者：刘士辰[1] 杨仁杰 张宏志 朱林忠 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]北京大学临床肿瘤学院介入科

出　　处：《实用放射学杂志》2003年第3期193-196,共4页Journal of Practical Radiology

基　　金：北京市卫生重点学科 (编号 :1 999卫科扶字 0 4号 )

摘　　要：目的　探讨经皮局部隔离肝脏灌注化疗的方法及可行性。方法　 12只实验用犬 ,对照组 4只 ,进行常规经肝动脉灌注化疗 ;实验组 8只 ,利用介入放射学方法进行经皮局部隔离肝脏灌注化疗结合血液灌流。化疗药物选用阿霉素 ,分别检测肝静脉及外周血液中的血药浓度。结果　实验组介入操作全部成功 ,1例死于血液灌流的血路管漏气 ,平均操作时间 ( 132 .3± 15 .3)min。血药浓度测定显示 ,对照组肝静脉血和外周静脉血浓度峰值分别为 ( 370 9.676± 385 .72 3)ng/ml、( 15 76.14 0± 2 2 6.933)ng/ml;实验组为( 465 3.42 0± 430 .2 0 4)ng/ml、( 433.612± 40 .5 0 1)ng/ml。统计学处理 ,两组相差非常显著。结论　经皮局部隔离肝脏灌注化疗结合血液灌流是一种可行的技术 ,具有简单、创伤小、可保护正常肝脏、便于重复治疗的优点。与常规经肝动脉灌注化疗相比 ,不仅可以增加局部血药浓度 ,更可以降低外周的血药浓度 。Objective To investigate methods and feasibility of percutaneous regional isolated hepatic perfusion combined with charcoal hemoperfusion(PRIHP-CHP).Methods Four out of 12 dogs underwent the procedure of routine transhepatic arterial infusion(TAI) as control group, 8 underwent PRIHP-CHP as experimental group. Adriamycin was used in our study, the concentration of plasma in hepatic vein and systemic vein was detected in both groups. Results All the procedures were successful in the PRIHP-CHP group eight, but 1 dog died because of air embolization. The average procedure duration for each was (132.3±15.3) minutes. The peak level of adriamycin concentration in hepatic vein and systemic in TAI were (3709.676±385.723) ng/ml and (1576.140±226.933) ng/ml respectively. In PRIHP-CHP, the peak level were (4653.420±430.204) ng/ml and (433.612±40.501) ng/ml. There were statistically significant differences between TAI and PRIHP-CHP (Ρ<0.01). Conclusion PRIHP-CHP is a feasible method which has many advantages such as simple, minimally invasive, normal liver can be protected, easy for retreatment. Compared with TAI, using the technology of PRIHP-CHP, the concentration of chemotherapeutic agents can increase in regional liver, and even more markedly decrease in systemic circulation.

关 键 词：隔离肝脏灌注 灌注化疗 介入放射学 血药浓度 毒副作用 动物实验 肝脏恶性肿瘤 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]