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目的分析和探讨平阳霉素碘化油乳剂(PLE)超选择肝段动脉栓塞在肝血管瘤介入治疗中的临床疗效。方法 57例肝血管瘤患者进行超选择动脉栓塞治疗,其中41例运用PLE联合聚乙烯醇颗粒进行栓塞治疗作为B组,16例选用超液态碘化油(LE)、适量造影剂联合聚乙烯醇颗粒制成乳剂进行栓塞作为A组,术后3~12个月观察碘油沉积、肿瘤大小变化及并发症的发生情况。结果所有患者术前肝动脉造影显示供血动脉轻度增粗,瘤体较大时可有受压移位征象。动脉早期血窦显影,血窦染色常维持到肝实质后期,持续不退,为“早出晚归”表现。栓塞后肿瘤内碘油沉积良好,造影复查血管瘤染色缺如,供血血管消失。两组患者第1次栓塞后12个月复查疗效比较,差异具有统计学意义(P<0.05)。结论平阳霉素碘化油乳剂联合聚乙烯醇颗粒动脉栓塞治疗肝血管瘤是一种疗效肯定、安全理想的治疗方法。
Objective To analyze and discuss the clinical effect of ultra-selective hepatic segmental arterial embolization of Pingyangmycin iodinated oil emulsion (PLE) in the interventional treatment of hepatic hemangioma. Methods Fifty-seven patients with hepatic hemangioma undergoing superselective arterial embolization were enrolled in this study. Forty-one patients were treated with PLE combined with polyvinyl alcohol particles for embolization. Group B included 16 patients with ultra-liquid iodized oil (LE) and appropriate contrast agent plus polyvinyl alcohol Granules made of emulsion embolization as A group, 3 to 12 months after operation to observe lipiodol deposition, tumor size changes and complications. Results All patients underwent preoperative hepatic arterial angiography showed a slight thickening of the feeding artery, the larger the tumor may have signs of pressure shift. Early arterial sinusoidal development, sinusoidal staining often maintained to the late parenchyma, persistent, as “early morning and evening ” performance. After the embolization of lipiodol deposition in the tumor, angiography review lack of hemangioma staining, blood vessels disappeared. The two groups of patients after the first embolization 12 months after the review of efficacy, the difference was statistically significant (P <0.05). Conclusion Pingyangmycin iodized oil emulsion combined with polyvinyl alcohol particles arterial embolization in the treatment of hepatic hemangioma is a positive effect, safe and ideal treatment.