摘要
目的评价介入栓塞治疗在高龄膀胱癌合并持续性出血中的疗效及安全性。方法回顾分析了使用介入化疗栓塞的办法,对71例高龄(年龄70～91岁,平均年龄77.9岁)膀胱癌合并持续性出血的患者行膀胱动脉或髂内动脉化疗栓塞治疗,其中19例实施了单侧栓塞,52例实施了双侧栓塞,16例加用了微弹簧圈栓塞。对术后血尿控制、栓塞后造影结果、并发症进行观察、随访,对疗效及安全性进行评估。结果技术成功率100%,71例患者中的58例平均3天(范围为2至5天)血尿停止(81.7%),9例转为镜下血尿(12.7%);其余3例行第二次栓塞术后出血停止,第二阶段的临床成功率为100%,一例放弃治疗。术后无严重不良反应。栓塞术后随访平均进行了15个月(15天至50个月),长期随访65例患者复发出血8例(12.3%)。在随访过程中有8名患者死亡,均由于基础疾病。结论介入化疗栓塞治疗膀胱癌合并持续性出血是安全和有效的方法。
Objective To evaluate the efficacy and security oftranscatheter arterial embolization for intractable bladder Hematuria in advanced age people. Methods We retrospectively studied the records of 71 patients （SD age of 77.9 ~17.2 years） for selective pelvic angiography after failed conventional therapy. Embolization was feasible in 71 patients, including bilateral and unilateral embolization in 52 and 19, respectively. It consisted of selective proximal coil or gelatin sponge particle occlusion of the anterior division of the internal lilac artery in 16, bleeding control and post- embolization angiography findings were used to assess outcomes. Results The technical success rate was 100% （70 of 71 cases）. Bleeding was controlled after the first procedure （2 days to 5 days after embolization） in 58 of 71 patients （81.7%）, 9 （12.7%）turned to be microscopic hematuria and a repeat procedure was succeeded in the remaining 3. No major complications related to catheterization occurred. Late bleeding recurrence was reported in 8 of the 65 survivors （12.3%）. Mean post-embolization follow up was 15 months （range 15 days to 50 months）. During follow up 8 patients died of basic disease. Conclusion Selective angiographic ernbolization is safe and effective to control refractory, life threatening bladder bleeding.
出处
《当代医学》
2012年第6期60-62,共3页
Contemporary Medicine
关键词
高龄
膀胱癌
血尿
介入放射学
动脉栓塞
Advanced age~ Urinary bladder
Hemorrhage
Embolization, Therapeutic
