平阳霉素―碘化油乳剂栓塞治疗肝血管瘤疗效分析.docVIP

平阳霉素―碘化油乳剂栓塞治疗肝血管瘤疗效分析 　　[摘要] 目的 分析经肝动脉等供血动脉行平阳霉素-碘化油乳剂栓塞肝血管瘤的临床疗效。方法 回顾性分析该院自2014年4月―2016年3月期?g60例肝血管瘤患者，共计76个血管瘤病灶，经肝动脉等供血动脉超选择插管后，注入平阳霉素-碘化油乳剂进行栓塞治疗。60例患者均具有完整的临床治疗过程及随访资料。 结果 54例1次栓塞，6例2次栓塞，随访12个月，肿瘤缩小50%以上者40例，不足50%者12例，缩小25%者8例，总有效率86.7%。结论 肝动脉等供血动脉栓塞治疗肝血管瘤，疗效确切、安全、并发症少，是肝血管瘤治疗的一种较理想的方法。 　　[关键词] 肝血管瘤；平阳霉素；动脉栓塞术；碘化油；介入治疗 　　[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2017）05（c）-0131-03 　　[Abstract] Objective To analyze the clinical curative effect of pingyang mycin lipiodol emulsion embolization in treatment of hepatic hemangioma. Methods 60 cases of patients with hepatic hemangioma admitted and treated in our department from April 2014 to March 2016 were selected， 76 hemangioma lesions in total， and the patients were treated with pingyang mycin lipiodol emulsion embolization and 60 cases of patients had the complete clinical treatment course and follow-up data. Results 1 embolism was in 54 cases， 2 embolisms were in 6 cases and the 12-month follow-up showed that there were 40 cases whose tumor decreased by 50% and 12 cases whose tumor decreased by less than 50%， and 8 cases whose tumor decreased by less than 25% and the total effective rate was 86.7%. Conclusion The curative effect of blood supply arterial embolism such as hepatic artery in treatment of hepatic hemangioma is definite and safety with few complications which is an ideal treatment method of hepatic hemangioma. 　　[Key words] Hepatic hemangioma； Pingyangmycin； Arterial embolism； Iodinated oil； Interventional treatment 　　肝海绵状血管瘤（Cavernous hemangioma of liver，CHL）是肝脏最常见的良性肿瘤，其人群发病率为4%～7%，女性多见，因肿瘤生长缓慢，50%～70%无临床症状[1]，部分患者可有腹胀、腹痛、恶心、呕吐，甚至有黄疸、贫血及血管瘤破裂出血的可能[2]。近年来，介入治疗方法及技术的发展，已经广泛应用于肝血管瘤的治疗，并取得良好的效果。该院自2014年4月―2016年3月采用经肝动脉等供血动脉超选择插管后注入平阳霉素+碘化油乳剂栓塞治疗肝血管瘤60例，收到了良好的效果，现就其治疗方法及临床价值作分析讨论，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　该院采用经肝动脉等供血动脉栓塞治疗肝脏血管瘤共60例；其中男性16例，女性44例；年龄24～54岁，平均年龄42.1岁；肿瘤最大直径26 cm，最小直径3 cm；肿瘤单发50例，多发10例，共计病灶76个。60例患者临床表现与肿瘤的部位、大小、生长速度及肝脏受累情况有关，大多数患者无明显临床表现，11例患者有腹胀、恶心、呕吐及长期低热，1例巨大病灶者有黄疸及贫血。全部病例术