摘要
目的探讨急诊超选择动脉栓塞(TAE)治疗自发性肝癌破裂出血的临床疗效。方法回顾性分析2011年10月—2015年10月南方医科大学附属上海奉贤区中心医院介入科24例自发性肝癌破裂出血患者的病例资料,其中巨块型肝癌18例,结节型5例,小肝癌1例。所有患者均行急诊肝动脉超选择性插管,采用弹簧圈、明胶海绵及碘化油等栓塞出血动脉,观察其临床疗效。结果 24例患者均得以有效止血。2例患者分别在栓塞术后第1、7天内成功被施行肝肿瘤切除术;15例患者经栓塞术后,根据病情多次行介入治疗,其中经导管动脉化疗栓塞(TACE)12例,CT引导下射频消融(CT-RFA)3例,肿瘤均有不同程度的缩小和坏死;7例未再进行介入及外科治疗。患者平均生存时间为13.7个月。结论急诊动脉栓塞是治疗自发性肝癌破裂出血安全有效的手段。在TAE止血后择期对肿瘤行IACE联合CT-RFA等治疗可取得良好效果。
Objective To investigate the clinical efficacy of emergency super selective arterial embolization （ TAE） in the treatment of spontaneous rupture of hepatocellular carcinoma （HCC）.Methods Retrospective analysis from October 2011 to October 2015 in Southern Medical University Affiliated Shanghai Fengxian District Central Hospital Department of in -terventional treatmed 24 cases of spontaneous rupture of hepatocellular carcinoma patients＇ clinical data , including 18 cases of massive type hepatocellular carcinoma , 5 cases of nodular type , small hepatocellular carcinoma in 1 case.All patients under-went emergency hepatic artery super selective catheterization , the coil, gelatin sponge and Lipi embolism arterial hemorrhage and observe its clinical curative effect .Results 24 patients were able to effectively stop bleeding .2 patients respectively 1, 7 days after embolization were successfully performed liver tumor resection;15 patients after embolization , according to the con-dition, received several time of interventional treatment by transcatheter arterial chemoembolization （TACE） in 12 cases, CT guided radiofrequency ablation （CT-RFA） in 3 cases, tumor had varying degrees of narrowing and necrosis;7 cases did not repeated interventional and surgical treatment .The mean survival time was 13.7 months.Conclusion Emergency arterial em-bolization is a safe and effective method in the treatment of spontaneous rupture of hepatocellular carcinoma .In TAE after he-mostasis,combination of TACE ,CT-RFA and other treatment can achieve good results .
出处
《疑难病杂志》
CAS
2016年第9期967-970,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
自发性破裂出血
肝癌
经导管动脉栓塞
急诊
经导管动脉化疗栓塞
Spontaneous rupture
hepatocellular carcinoma
Transcatheter arterial embolization
Emergency
Transcatheter arterial chemoembolization
