肝癌合并不同类型动静脉瘘的介入治疗方法探索 王曙初1 陈燕浩2 张树桐.docVIP

精品论文 参考文献 肝癌合并不同类型动静脉瘘的介入治疗方法探索 王曙初1 陈燕浩2 张树桐 王曙初1 陈燕浩2 张树桐2 　　(1武汉市黄陂区中医医院 湖北武汉 430300) 　　(2武汉市中心医院 湖北武汉 430014) 　　【摘要】目的 探讨肝癌合并动静脉瘘的介入治疗方法。方法 回顾性分析125例肝癌患者行DSA造影，判断有无动静脉瘘，再根据实际情况选择实行肝动脉内化疗栓塞治疗或肝动脉内化疗术，比较两者之间的疗效。结果 DSA诊断肝癌合并动静脉瘘者54例，中央型动门静脉瘘17例，周围型动门静脉瘘28例，混合型9例，轻度动门脉瘘22例，中度动门脉瘘17例(图1-2)，重度动门脉瘘15例。低流量型29例，高流量型25例。42例行肝动脉内化疗栓塞术，12例行肝动脉内化疗术。术后，所有患者肝功能均有不同程度好转，行肝动脉内化疗栓塞术中位生存时间，2月、6月、1年总体累积生存率均高于肝动脉内化疗术患者。结节型及巨块型肝癌中位生存时间，2月、6月、1年总体累积生存率相当，且均明显高于弥漫型肝癌。结论 周围型、轻中度及低流量动静脉瘘的患者封堵瘘口较容易，而中央型、混合型、重度及高流量型动静脉瘘患者封堵瘘口难度较大，应尽可能以栓塞剂有效封堵瘘口处局部血流，随即行TACE，如封堵瘘口无效，则仅行TAI。 　　【关键词】肝癌 动静脉瘘 肝动脉内化疗栓塞术 肝动脉内化疗术 　　【中图分类号】R730.53 【文献标识码】A 【文章编号】2095-1752（2014）15-0036-03 　　Interventional Therapy of hepatic carcinoma complicated by Hepatic arterial-portal venous shunts of various type. 　　 Wang shuchu Chen yanhao Zhang shutong 　　Huangpi District Hospital of traditional Chinese Medicine ,WuhanCity 430300 　　WuhanCentral Hospital 430014 　　【Abstract】 Objective To explore the interventional therapeutic methods for hepatocellular carcinoma accompanied with arterioveneus shuunt. Methods 125 cases with proved HCC were underwent DSA firstly, judge whether to exist Hepatic arterial-portal venous shunts. then transcatheter arterial chemoembolization (TACE) or transcatheter arterial infusion (TAI) were performed in all cases . we compared with the therapeutic effect of TACE with the one of TAI. Results Totally 54 cases were presented with arteriovenous shunt, including 17 cases with hepatic artery-portal vein shunts of central type, 28 cases with the ones of peripheral type, 9 cses with the ones of mixed type, 22 cases with the ones of mild type , 17 cases with the ones of midrange type, 15 cases with the ones of heavy type, 29 cases with the ones of low-flow type, 25 cases with the ones of high-flow type . Hepatic function was improved after interventional therapy. The median survival time,two months survival rate, six months survival rate an