动脉栓塞术治疗肝血管瘤的远期疗效评价-现代医学

动脉栓塞术治疗肝血管瘤的远期疗效评价

作者：李书书¹ 何仕诚² 方文² 朱海东² 郭金和² 朱光宇² 邓钢² 杜瑞杰²

单位：1. 东南大学医学院医学影像系, 江苏南京 210009;
2. 东南大学附属中大医院介入与血管外科, 江苏南京 210009

分类号：R735.7

出版年·卷·期（页码）：2018·46·第八期（881-886）

摘要：

目的：评价动脉栓塞术（TAE）治疗肝血管瘤的远期疗效及术后瘤体大小变化规律。方法：回顾性分析2005年1月至2017年1月治疗的肝血管瘤137例155个瘤体，采用碘化油与平阳霉素混合乳剂及明胶海绵颗粒栓塞瘤体供血动脉，术后定期复查CT评价瘤体大小并计算平均缩小率，比较1个月内肝肾功能变化。结果：所有瘤体均栓塞成功。TAE后随访时间点6个月、6月~1年、1~3年、3~5年及5~12年CT测量瘤体平均缩小率分别为61.6%、72.2%、83.9%、88.3%及89.9%，其中TAE后3年内3个随访点瘤体呈逐步缩小，均有显著性差异（P<0.05），余随访点无显著性差异（P>0.05）。TAE后1周AST及ALT较术前均有显著性差异（P<0.05），但ALB、Tbil、Dbil、Bun、Cr较术前均无显著差异（P>0.05）；TAE后1个月AST及ALT较术前均无显著差异（P>0.05）。无严重并发症发生。结论：TAE治疗肝血管瘤安全、远期疗效显著；术后1年内瘤体进行性缩小，1~12年期间瘤体缩小趋于稳定。

Objective:To evaluate the long-term efficacy and tumor shrinkage after transcatheter arterial embolization(TAE) of hepatic hemangioma(HH). Methods:A total of 137 HH patients with 155 lesions were retrospectively analyzed in our institution from January 2005 to January 2017. TAE was carried out using Pingyang mycin-lipiodol emulsion and gelfoam particles. The efficacy was assessed by the change of the size of tumor on CT after treatment during followed-up. The liver and renal function before TAE, 1 week and 1 month after TAE was compared. Results:The successful rate of TAE was 100%. The average reduction rate of 6 months, 6 months to 1 years, 1 to 3 years, 3 to 5 years and 5 to 12 years were 61.6%, 72.2%,83.9%,88.3%and 89.9% respectively, there were significant differences of reduced averaged tumor size at three follow-up points in 3 years after TAE and no significant differences beyond 3 years after TAE. There were significant differences of AST and ALTone week after TAE compared topreprocedure, moreover, AST and ALT averagely increased by 52.8U·L^-1 and 57.7U·L^-1 respectively, however, ALB, Tbil, Dbil, Bun and Cr were not significantly different from those before operation. 1 months after TAE, there were no significant differences in AST, ALT, ALB, Tbil, Dbil, Bun and Cr compared with those before operation. Conclusion:TAE is safe and effective in the treatment of HH and the long-term effect is significant. After embolization, the size of the tumor gradually reduces in one year after TAE,and then tends to be stable after in 12 years.

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