摘要
目的探讨经皮选择性肝脏隔离灌注化疗的可行性及隔离效果。方法将12只猪随机分为两组:HAI组6头,进行常规经肝动脉灌注化疗;PSIHP组6头,利用介入放射学方法进行经皮选择性隔离肝脏灌注化疗结合血液灌流。化疗药物选用5-FU。分别检测肝静脉及外周血液中的血药浓度,并对肝组织行病理学检查。结果HAI组右肝静脉血和外周静脉血浓度峰值分别为(4082.530±415.213)mg/L,(1682.230±216.834)mg/L;PSIHP组右肝静脉血、外周静脉血血药浓度峰值分别为(5321.711±517.318)mg/L,(510.834±52.518)mg/L。两组间有显著性差异(P<0.01)。PSIHP组过滤后肝静脉血血药浓度峰值为(1192.063±114.864)mg/L,碳肾率过滤达到(77.6±0.9)%。PSIHP组灌注区域肝脏组织损害程度比HAI组大。结论PSIHP是一种简单有效的肝脏隔离灌注化疗技术,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,降低毒副作用。
ObjectiveTo investigate the feasibility and isolation efficiency of percutaneous selective isolated hepatic perfusion chemotherapy(PSIHP). MethodsSix pigs underwent the procedure of routine transhepatic arterial infusion(HAI) and 6 underwent PSIHP.5-FU was used in this study. The drug(5-FU) (concentration) of blood from hepatic and systemic veins of both groups was observed. Liver tissue was (investigated) for pathologic changes. ResultsThe peak level of 5-FU concentration in blood from right (hepatic) vein and systemic vein in HAI group was(4082.530415.213)mg/L and (1682.230216.834)mg/L respectively.In PSIHP group, the peak level(5-FU) was(5321.711517.318)mg/L and(510.83452.518)mg/L, respectively.There was a statistically significant difference between HAI group an PSIHP group(P<0.01). The level of 5-FU concentration in blood from right hepatic vein of PSIHP group(postfiltration) was(1192.063114.864)mg/L and the filtration rate of charcoal (hemoperfusion) was(77.60.9%). The damage of perfused area of liver tissue was more serious in PSIHP group compared with HAI group. ConclusionsPSIHP is a simple and feasible method for isolated hepatic perfusion. Compared with HAI, PSIHP can increase the concentration level of chemotherapeutic agents in (regional) liver, and can even more markedly decrease the drug concentration in systemic circulation and (decrease) toxic side effcts.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第7期505-508,共4页
China Journal of General Surgery
基金
广东省深圳市科技局基金资助项目(200104087)。
