AIM:To evaluate long-term effect of ethanol embolization for the treatment of hepatocellular carcinoma (HCC) with severe hepatic arterioportal shunt (APS), compared with Gelfoam embolization.METHODS:Sixty-four patient...AIM:To evaluate long-term effect of ethanol embolization for the treatment of hepatocellular carcinoma (HCC) with severe hepatic arterioportal shunt (APS), compared with Gelfoam embolization.METHODS:Sixty-four patients (ethanol group) and 33 patients (Gelfoam group) with HCC and APS were respectively treated with ethanol and Gelfoam for APS before the routine interventional treatment for the tumor. Frequency of recanalization of shunt, complete occlusion of the shunt,side effects, complications, and survival rates were analyzed between the two groups.RESULTS: The occlusion rate of APS after initial treatment in ethanol group was 70.3%(45/64), and recanalization rate of 1 month after embolization was 17.8%(8/45),and complete occlusion rate was 82.8%(53/64).Those in Gelfoam group were 63.6%(21/33), 85.7%(18/21), and 18.2%(6/33).There were significant differences in recanalization rate and complete occlusion rate between the two groups (P<0.05).The survival rates in ethanol group were 78% at 6 months,49% at 12 months, 25% at 24 months, whereas those in Gelfoam group were 58% at 6 months, 23% at 12 months,15% at 24 months.The ethanol group showed significantly better survival than Gelfoam group (P<0.05). In the ethanol group, there was a significant prolongation of survival in patients with monofocal HCC (P<0.05) and Child class A (P<0.05).There were no significant differences in survival rate in the Gelfoam group with regard to the number of tumor and Child class (P>0.05). The incidence rate of abdominal pain during procedure in ethanol group was 82.8%.There was no significant difference in postembolization syndromes between two groups. Procedure-related hepatic failure did not occur in ethanol group.CONCLUSION: Ethanol embolization for patients with HCC and severe APS is efficacious and safe, and may contribute to prolongation of the life span versus Gelfoam embolization.展开更多
背景:随着生物医用高分子材料如纤维素、甲壳素等天然高分子材料以及聚乙烯醇、胶原等合成高分子材料的研发,止血材料的运用和发展获得了飞跃。目的:文章综述了近年来不同种类高分子止血敷料的研究进展,评价了不同种类复合止血敷料的临...背景:随着生物医用高分子材料如纤维素、甲壳素等天然高分子材料以及聚乙烯醇、胶原等合成高分子材料的研发,止血材料的运用和发展获得了飞跃。目的:文章综述了近年来不同种类高分子止血敷料的研究进展,评价了不同种类复合止血敷料的临床应用价值。方法:应用计算机检索万方和PubMed数据库中1996-01/2010-12关于医用高分子止血敷料研究应用的文章,在标题和摘要中以"止血材料;纤维蛋白;高分子材料;胶原蛋白;明胶海绵"或"biological;occlude the flow of blood;gelatin sponge fibrae sanguis"为检索词进行检索。选择医用高分子止血敷料领域发表在近期文献或权威杂志上的文章。初检得到126篇文献,根据纳入标准选择28篇文章进行综述。结果与结论:近年来国内外主要应用的可吸收止血材料包括壳聚糖、纤维蛋白胶、吸收性明胶海绵、微纤维胶原等以及常用的按材质和用途分类的藻酸盐类和水胶体类,不同的止血材料其止血机制和止血效果均不相同。文章通过对多种复合止血材料的效果进行比较观察,说明了各种止血材料止血途径和止血机制还有待进一步的研究,以便于开发出更卓越、更有效的止血材料。展开更多
文摘AIM:To evaluate long-term effect of ethanol embolization for the treatment of hepatocellular carcinoma (HCC) with severe hepatic arterioportal shunt (APS), compared with Gelfoam embolization.METHODS:Sixty-four patients (ethanol group) and 33 patients (Gelfoam group) with HCC and APS were respectively treated with ethanol and Gelfoam for APS before the routine interventional treatment for the tumor. Frequency of recanalization of shunt, complete occlusion of the shunt,side effects, complications, and survival rates were analyzed between the two groups.RESULTS: The occlusion rate of APS after initial treatment in ethanol group was 70.3%(45/64), and recanalization rate of 1 month after embolization was 17.8%(8/45),and complete occlusion rate was 82.8%(53/64).Those in Gelfoam group were 63.6%(21/33), 85.7%(18/21), and 18.2%(6/33).There were significant differences in recanalization rate and complete occlusion rate between the two groups (P<0.05).The survival rates in ethanol group were 78% at 6 months,49% at 12 months, 25% at 24 months, whereas those in Gelfoam group were 58% at 6 months, 23% at 12 months,15% at 24 months.The ethanol group showed significantly better survival than Gelfoam group (P<0.05). In the ethanol group, there was a significant prolongation of survival in patients with monofocal HCC (P<0.05) and Child class A (P<0.05).There were no significant differences in survival rate in the Gelfoam group with regard to the number of tumor and Child class (P>0.05). The incidence rate of abdominal pain during procedure in ethanol group was 82.8%.There was no significant difference in postembolization syndromes between two groups. Procedure-related hepatic failure did not occur in ethanol group.CONCLUSION: Ethanol embolization for patients with HCC and severe APS is efficacious and safe, and may contribute to prolongation of the life span versus Gelfoam embolization.
文摘背景:随着生物医用高分子材料如纤维素、甲壳素等天然高分子材料以及聚乙烯醇、胶原等合成高分子材料的研发,止血材料的运用和发展获得了飞跃。目的:文章综述了近年来不同种类高分子止血敷料的研究进展,评价了不同种类复合止血敷料的临床应用价值。方法:应用计算机检索万方和PubMed数据库中1996-01/2010-12关于医用高分子止血敷料研究应用的文章,在标题和摘要中以"止血材料;纤维蛋白;高分子材料;胶原蛋白;明胶海绵"或"biological;occlude the flow of blood;gelatin sponge fibrae sanguis"为检索词进行检索。选择医用高分子止血敷料领域发表在近期文献或权威杂志上的文章。初检得到126篇文献,根据纳入标准选择28篇文章进行综述。结果与结论:近年来国内外主要应用的可吸收止血材料包括壳聚糖、纤维蛋白胶、吸收性明胶海绵、微纤维胶原等以及常用的按材质和用途分类的藻酸盐类和水胶体类,不同的止血材料其止血机制和止血效果均不相同。文章通过对多种复合止血材料的效果进行比较观察,说明了各种止血材料止血途径和止血机制还有待进一步的研究,以便于开发出更卓越、更有效的止血材料。
