小儿腹部恶性肿瘤的介入治疗 _医学论文.doc免费

小儿腹部恶性肿瘤的介入治疗 _医学论文 小儿腹部恶性肿瘤的介入治疗 _医学论文 【摘要】目的：探讨对一期手术切除困难的腹部恶性肿瘤术前行介入治疗的意义。材料和方法：对13例腹部恶性肿瘤进行介入治疗，肝母细胞瘤6例，神经母细胞瘤4例，肾母细胞瘤2例，肾上腺皮质癌1例。所有病例先行动脉插管造影，确定肿瘤主要供血动脉，对肿瘤供血动脉行超选择性插管，局部注入化疗药物及栓塞剂。结果：13例中7例手术切除了肿瘤，1例剖腹探查。余5例通过介入治疗后，肿瘤缩小。13例病人随访6～13个月，生存11例。结论：介入治疗可保证肿瘤局部高浓度化疗药物灌注，减少全身副作用；又可阻断肿瘤血供，使肿瘤缺血坏死，达到治疗目的。同时栓塞后，肿瘤包膜增厚，有利于手术中完整切除肿瘤。 　Interventional treatment of abdominal malignant neoplasm in children 　　【Abstract】Objective：To investigate the significance of interventional treatment before radical resection of the abdominal neoplasm in children.Methods： ALL of 13 patients with abdominal malignant tumor received interventional therapy. They were 6 cases of hepatoblastoma,4 of neuroblastoma,2 of nephroblastoma and 1 of adrenocortical carcinoma. The procedure was transarterial chemoembolotherapy.In the procedures precise arterography was performed to find out the feeding artery of the malignancy.And then superselective catheterization of those arteries was perfomed to obtanin better therapeutic results.Gelform particles and lipid iodine were applied in the embolization.Results：The neoplasms w ere entirely removed in 7 cases out of 13. In the other 6 patients, the tumors were unresectable.The tumors shrank after the interventional chemoembolotherapy in 5 patients.Eleven patients out of 13 survived till now in the 18 months follow-up period.Conclusions：Interventional treatment (transarterial chemoembolotherapy) will ensure the high dose chemotherapy to be given,and decrease the systemic side effects. Embolization blocks the arterial supply of tumor,which results in the ischemia and necrosis of the tumor. And the malignant neoplasms will be thickly capsulated after interventional procedures,making radical resection possible. 　　Key words：Malignant tumor AbdominalRadiologyInterventionalChildren 　　大多数小儿腹部恶性肿瘤患儿就诊时，多已属晚期，肿瘤已较大，与周圈血管粘连甚紧，手术难以完整切除，需先行化疗等辅助疗法，待其缩小再施行择期手术〔1、2〕。我院对13例巨大腹部恶性肿瘤患儿施行手术前介入治疗，现报道如下。 　　1材料与方法 　　1．1一般资料 　　l997年7月～1998年12月我院对13例小儿腹部巨大恶性肿瘤进行手术前介入治疗。其中男7例，女6例。年龄最小2