微创医学

目的总结经导管肝动脉超选择性栓塞硬化治疗富血供肝海绵状血管瘤的临床疗效。方法对12例富血供肝脏海绵状血管瘤患者,采用超选择性肝动脉插管行平阳霉素碘油乳剂栓塞硬化治疗,观察治疗前后患者肝功能和血管瘤大小的变化以及栓塞治疗相关并发症。结果本组所有患者均成功实施了栓塞治疗,术后1周复查肝功能显示:ALT、AST、TBIL及IBIL水平较治疗前增高,给予护肝治疗2周后各项指标逐渐下降,术后1个月复查肝功能均恢复正常;术后3个月、6个月分别复查增强CT,见血管瘤增强效应消失,其内碘油沉积良好。血管瘤术前平均直径(6.74±2.16)cm,术后3个月、6个月平均直径分别为(5.74±1.34)cm和(3.15±0.90)cm(P<0.05)。患者术后未出现胆囊坏死、胆管狭窄和肝坏死等严重并发症。结论经导管肝动脉超选择性栓塞硬化治疗富血供肝脏海绵状血管瘤是一种安全、有效、微创的治疗方法。

Objective To evaluate the clinical efficacy of transcatheter hepatic arterial embolization in treating the rich blood supply liver cavernous hemangioma． Method 12 patients with abundant blood supply hepatic cavernous hemangioma were treated by super-selective hepatic artery embolization with pingyangmycin lipiodol emulsion． All patients were observed before and after treatment with liver function，changes in the size of hemangioma and complication of embolization． Results All patients were successfully performed with embolization． Liver function examination showed: compared with the level before the surgery，the level of ALT， AST，TBIL and IBIL increased 1 week after the surgery，but after 2 weeks of liver protection therapy，they gradually decreases，and restored to normal 1 month after surgery． Enhanced CT after 3 months and 6 months after the surgery showed: hemangioma enhancement effect disappeared，and lipiodol deposited well． The hemangioma preoperative average diameter was ( 6． 74 ± 2． 16) cm，and it decreased to ( 5． 74 ± 1． 34) cm and ( 3． 15 ± 0． 90) cm 3 months and 6 months after surgery，respectively ( P ＜ 0． 05) ． Cystic necrosis，bile duct stenosis，liver necrosis，or other serious complications was no observed． Conclusion Transcatheter hepatic arterial embolization in treating rich blood supplying liver cavernous hemangioma is safe，effective，and minimally invasive．