• 四川大學(xué)華西醫(yī)院腫瘤中心腹部腫瘤科,四川成都 610041;

目的:探討經(jīng)肝動(dòng)脈導(dǎo)管注射明膠海綿碘化油乳劑治療肝癌合并嚴(yán)重動(dòng)靜脈瘺的可行性及臨床應(yīng)用價(jià)值。方法:對(duì)38例肝癌動(dòng)靜脈瘺患者血管分別行超選擇插管注射明膠海綿碘化油乳劑,造影觀察動(dòng)靜脈瘺的栓塞率,血管再通率,副作用,并發(fā)癥及生存率等指標(biāo)。結(jié)果:38例肝癌動(dòng)靜脈瘺患者經(jīng)肝動(dòng)脈導(dǎo)管注入明膠海綿碘化油乳劑約2~10mL栓塞,栓塞后造影顯示閉塞率為94.7%(36/38),4周后造影顯示動(dòng)靜脈瘺再通率為5.56%(2/36),未見(jiàn)確切不良反應(yīng),腫瘤碘化油乳劑沉積好,患者6月生存率為94.7%(36/38),12月生存率為60.5%(23/38),24月生存率為21.1%(8/38)。結(jié)論:經(jīng)肝動(dòng)脈導(dǎo)管注射碘化油乳劑治療肝癌動(dòng)靜脈瘺安全可靠,對(duì)瘺口要求不高,栓塞率高,再通率低,腫瘤的栓塞治療效果好。

引用本文： 李俊,廖正銀,游昕,羅勇. 明膠海綿碘化油乳劑栓塞治療肝癌動(dòng)靜脈瘺的臨床應(yīng)用. 華西醫(yī)學(xué), 2009, 24(5): 1193-1195. doi: 復(fù)制

1.
2.
3. KIDO C, SASAKI T, KANEKO M. Angiography of primary liver cancer[J]. Am J Roentgenol Radium Ther Nacl Med,1971,113:7081.
4. NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
5. OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
6. FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
7. OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
8. LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
9. 汪邵平,徐位頓,霍楓,等,肝癌合并動(dòng)靜脈瘺71例的診治體會(huì)[J].中華普通外科雜志,2003,18:8486.
10. KIM Y J, LEE H G, PARK J M, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts[J]. Korean J Radiol,2007,8:311319.
11. TARAZOV P G. Intrahepatic arterioportal fistulae: role of transcatheter embolization[J]. Cardiovasc Intervent Radiol,1993,16:368373.
12. CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
13. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
14. 張電波,肖湘生.肝癌伴肝動(dòng)—靜脈瘺的血管造影表現(xiàn)及其臨床意義[J].中國(guó)醫(yī)學(xué)影像雜志2001,9(5):356357.
15. VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
16. LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
17. 劉崎,田建明,賈雨辰,等.肝癌并門脈主干癌栓的介入治療及其預(yù)后的影響因素[J].中華放射學(xué)雜志,1999,33(8):538541.
18. 羅鵬飛,陳曉明,張良明,等.肝癌合并動(dòng)靜脈瘺的處理方法探討[J].中華放射學(xué)雜志,2002,36(2):114117.
19. 關(guān)守海,單鴻,姜在波,等.經(jīng)微導(dǎo)管局部灌注無(wú)水乙醇治療肝癌高流量性動(dòng)靜脈瘺[J].中華放射學(xué)雜志,2002,36:9971000.
20. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.
  1. 1.
  2. 2.
  3. 3. KIDO C, SASAKI T, KANEKO M. Angiography of primary liver cancer[J]. Am J Roentgenol Radium Ther Nacl Med,1971,113:7081.
  4. 4. NGAN H, PEH W C. Arteriovenous shunting in hepatocellularcarcinoma: its prevalence and clinical significance[J]. Clin Radiol,1997,52:3640.
  5. 5. OKUDA K, MUSHA H, YAMASAKI T, et al. Angiographic demonstration of intrahepatic arterioportal anastomoses in hepatocellular carcinoma[J]. Radiology,1977,122:5358.
  6. 6. FURUSE J, IWASAKI M, YOSHINO M, et al. Hepatocellular carcinoma with portal vein tumor thrombus embolization of arterioportal shunts[J]. Radiology,1997,204:787.
  7. 7. OKUYAMA M, FUJIWARA Y, HAYAKAWA T, et al. Esophagogastric varices due to arterioportal shunt in a serous cystadenoma of the pancreas in von HippelLindau disease[J]. Dig Dis Sci,2003,48:19481954.
  8. 8. LAZARIDIS K N, KAMATH P S. Images in hepatology. Arterioportal fistula causing recurrent variceal bleeding[J]. J Hepatol,1998,29:142.
  9. 9. 汪邵平,徐位頓,霍楓,等,肝癌合并動(dòng)靜脈瘺71例的診治體會(huì)[J].中華普通外科雜志,2003,18:8486.
  10. 10. KIM Y J, LEE H G, PARK J M, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts[J]. Korean J Radiol,2007,8:311319.
  11. 11. TARAZOV P G. Intrahepatic arterioportal fistulae: role of transcatheter embolization[J]. Cardiovasc Intervent Radiol,1993,16:368373.
  12. 12. CLARK R A, FREY R T, COLLEY D P, et al. Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia[J]. Gastrointest Radiol,1981,6:353356.
  13. 13. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterialembolization for HCC hepatocellular carinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787 790.
  14. 14. 張電波,肖湘生.肝癌伴肝動(dòng)—靜脈瘺的血管造影表現(xiàn)及其臨床意義[J].中國(guó)醫(yī)學(xué)影像雜志2001,9(5):356357.
  15. 15. VELAZQUEZ R F, RODRIGUEZ M, NAVASCUES C A, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J]. Hepatology,2003,37:520527.
  16. 16. LIN S C, SHIH S C, KAO C R, et al. Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis[J]. World J Gastroenterol,2003,9:12081211.
  17. 17. 劉崎,田建明,賈雨辰,等.肝癌并門脈主干癌栓的介入治療及其預(yù)后的影響因素[J].中華放射學(xué)雜志,1999,33(8):538541.
  18. 18. 羅鵬飛,陳曉明,張良明,等.肝癌合并動(dòng)靜脈瘺的處理方法探討[J].中華放射學(xué)雜志,2002,36(2):114117.
  19. 19. 關(guān)守海,單鴻,姜在波,等.經(jīng)微導(dǎo)管局部灌注無(wú)水乙醇治療肝癌高流量性動(dòng)靜脈瘺[J].中華放射學(xué)雜志,2002,36:9971000.
  20. 20. FURUSE J, IWASAKI M, YOSHINO M, et al. Intraarterial embolization for HCC carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts[J]. Radiology,1997,204:787790.