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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。
Objective To investigate the feasibility and isolation effect of percutaneous selective liver perfusion chemotherapy. Methods Twelve pigs were randomly divided into two groups: HAI group (n = 6), conventional hepatic arterial infusion chemotherapy and PSIHP group (n = 6). Percutaneous selective hepatic perfusion chemotherapy combined with hemoperfusion was performed by interventional radiology. Chemotherapy drug selection 5-FU. Blood concentrations of hepatic vein and peripheral blood were detected, and pathological examination of liver tissue was performed. Results The peak values of right hepatic vein and peripheral venous blood in HAI group were (4082.530 ± 415.213) mg / L and (1682.230 ± 216.834) mg / L, respectively. The peak values of right hepatic vein and peripheral venous blood in PSIHP group were ( 5321.711 ± 517.318) mg / L, (510.834 ± 52.518) mg / L. There was a significant difference between the two groups (P <0.01). In the PSIHP group, the peak value of hepatic venous blood was (1192.063 ± 114.864) mg / L and the carbon filter rate was (77.6 ± 0.9)%. PSIHP group perfusion area liver tissue damage than the HAI group. Conclusions PSIHP is a simple and effective technique of hepatic isolation and perfusion chemotherapy. Compared with conventional transcatheter hepatic arterial infusion chemotherapy, PSIHP can not only increase local plasma concentration, but also reduce peripheral blood concentration and reduce side effects.