原发性肝癌肝外动脉供血及其临床治疗意义.docVIP

原发性肝癌肝外动脉供血及其临床治疗意义 　　作者：班永光　唐军　尚建强　刘作勤　孙增涛　陈颉 作者单位：山东大学山东省医学影像学研究所　(山东　济南　250021) 　　【摘要】目的：探讨原发性肝癌肝外动脉供血类型的分类、一般供血规律及其对临床治疗的意义。方法：回顾性分析185例原发性肝癌患者行经导管肝动脉化疗栓塞(TACE)术的DSA检查结果，对肝外动脉供血类型进行分类。结果：185例患者中存在215条肝外供血动脉，采用三分类法将其分为3类：1.变异肝动脉供血130条，占60.47%;2.肝动脉通畅肝外侧支供血35条，占16.28%;3.肝动脉闭塞或狭窄肝外侧支供血50条，占23.26%。其中后2类为非肝动脉供血。第1类以第1次TACE术时发现为主，第2类及第3类以第3次及以后TACE术时发现为主。非肝动脉供血与肝动脉通畅与否有关系。结论：原发性肝癌肝外动脉供血三分类法是一种较新的分类方法，具有简洁明晰的特点，对分析其类型与TACE术次数及肝动脉通畅与否的关系、指导肝癌的临床治疗具有重要作用。 　　【关键词】 肝肿瘤　肝动脉　侧支循环　经导管肝动脉化疗栓塞 　　Extrahepatic arterial blood supply of primary hepatic carcinoma and the clinical therapy 　　BAN Yong-guang, TANG-Jun, SHANG Jian-qiang, LIU Zuo-qin， SUN Zeng-tao, CHEN Jie 　　Shandong Medical Imaging Research Institute，Shandong University (Jinan 250021，China) 　　【ABSTRACT】 Objective：To discuss the classification, regularity of blood supply and the significance of clinical therapy of extrahepatic artery blood supply of primary hepatic carcinoma. Methods：The DSA results of 185 cases of primary hepatic carcinoma were checked by transcatheter arterial chemotherapy embolism (TACE) technique retrospectively, and the extrahepatic artery blood supply was classified into different types. Results：There were 215 extrahepatic arteries in 185 cases，and three types were included：1. The variant hepatic artery blood supply (130, 60.5%);2. Unobstructed extrahepatic blood supply of hepatic arteries (35,16.3%);3. Occlusive or narrow extrahepatic blood supply of hepatic arteries (50, 23.3%). The last two types are not the hepatic arteries. Conclusions: It was important to analyze the relation between times of TACE and unobstructed hepatic arteries, and it was valuable in the treatment of hepatic carcinoma. 　　【KEY WORDS】 Liver neoplasms·Hepatic artery·Collateral circulation·Transcatheter Arterial Chemotherapy Embolism 　　经导管肝动脉化疗栓塞(transcatheter arterial chemotherapy embolism, TACE)术是较常用、有效的原发性肝癌的治疗方法之一，尤其是对于无法手术切除的中晚期肝癌。但术后常常会遇到肿瘤残留或复发，主要原因之一就原发性肝癌存在丰富的肝外供血动脉。为此，本研究分析了185例原发性肝癌