摘要
目的 探讨肝总动脉（CHA）闭塞后经动脉化疗栓塞（TACE）治疗原发性肝癌（PLC）的可行性及效果.方法 回顾性分析9例PLC患者CHA闭塞后经侧支循环行TACE治疗的临床及影像学资料.结果 本研究入组1 782例PLC患者,共行4 771次TACE治疗,平均2.7次/人.9例患者出现CHA脉闭塞,发生率为0.5％（按人数计算）、0.19％（按TACE次数计算）.第一、二、三、四、五、六次TACE后出现CHA闭塞者分别为1例、1例、2例、2例、2例、1例.9例发生CHA闭塞的患者平均行TACE 3.7次/人,明显高于总体的2.7次/人（P＜0.05）.7例CHA存在不同程度的迂曲.CHA闭塞与术中使用5F导管、CHA迂曲及TACE次数有关.9例患者均经侧支循环行TACE治疗.术后4～6周复查CT均提示碘油沉积良好,达到了有效控制肿瘤的目的.结论 对于CHA闭塞的PLC患者,经侧支循环行TACE治疗是安全、可行的,具有与CHA途径行TACE治疗同样的疗效.
Objective To evaluate the feasibility and efficacy of transcatheter arterial chcmoembolizations （TACE） through collateral arteries in patients with common hepatic artery （CHA） occlusion.Methods A retrospective study was carried out on 9 patients with CHA occlusion who underwent TACE through collateral arteries.Results In 1 782 patients with primary liver cancer （PLC）,4 771 TACE procedures were carried out （a mean 2.7 sessions per patient）.The rate of CHA occlusion was 0.5％ （9/1 782）per patient and 0.19％ （9/4 771） per TACE procedure.CHA occlusion occurred after the first,second,third,fourth,fifth,sixth TACE procedure in 1,1,2,2,2,and 1 patients respectively （a mean 3.7 session per patient in these 9 patients） （P ＜0.05）.A tortuous CHA was present in 7 patients.CHA occlusion was related to the use of a 5 F catheter,tortuous CHA,and number of TACE.All the 9 patients with occluded CHA underwent TACE through collateral arteries,and good lipiodol deposition was detected on CT scan 4-6 weeks later.Conclusion TACE carried out through collateral arteries is safe and feasible in patients with CHA occlusion.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2014年第12期852-854,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
原发性肝癌
肝总动脉
闭塞
介入治疗
Primary liver cancer
Common hepatic artery, occlusion
Interventional therapy
