肝癌膈下动脉化疗栓塞术致脊髓损伤康复治疗1例报道.PDF

中国康复理论与实践2018年4月第24卷第4期 ChinJRehabilTheoryPract,Apr.,2018,Vol.24,No.8 - 472 - DOI: 10.3969/j.issn. 1006-9771.2017.00.002 ·临床观察 · 肝癌膈下动脉化疗栓塞术致脊髓损伤康复治疗1 例报道① 刘宏炜，李军，杜良杰 1. 中国康复研究中心北京博爱医院脊柱脊髓神经功能重建科，北京市100068；2. 首都医科大学康复医学院，北 京市100068。 通讯作者：刘宏炜。E-mail: Hongwei_liu@ [摘要] 目的 提高对肝癌膈下动脉经动脉导管化疗栓塞术(TACE)并发脊髓损伤的认识。 方法 回顾分析1例肝癌膈下动脉TACE 并发脊髓损伤患者的临床资料，结合相关文献报道，探讨其可能的发病 机制、危险因素、治疗和康复预后情况。 结果 膈下动脉同脊髓供血动脉之间的交通支开放是TACE 导致脊髓损伤的解剖学基础，而造影剂、化疗药、 栓塞剂和治疗介入次数均可成为脊髓损伤的致病因素。这种脊髓损伤多是一过性的，绝大部分患者经过 早期康复治疗均可在发病数周至数月内得到良好的功能恢复。 结论 肝癌行经膈下动脉TACE 并发脊髓损伤非常少见，在早期发现和得到及时的康复治疗后，功能预后较好。 [关键词] 肝癌；化疗栓塞术；脊髓损伤；危险因素；康复；预后 Rehabilitation of Spinal Cord Injury Occured after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma via Inferior Phrenic Artery: A Case Report LIU Hong-wei, LI Jun, DU Liang-jie 1. Department of Spinal and Neural Functional Reconstruction, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing 100068, China; 2. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China Correspondence to LIU Hong-wei. E-mail: Hongwei_liu@ Abstract Objective To further explore the complication of spinal cord injury occured after transcatheter arterial chemoemboliza- tion (TACE) for hepatocellular carcinoma via inferior phrenic artery. Methods The clinical and imaging data of one patient with spinal cord injury caused by TACE for hepatocellular carci- noma via inferior phrenic artery was retrospectively analyzed. The pathologic mechanism, risk factors and out- come of rehabilitative treatment were discussed after literature review. Results The abnormal opening of communicating branches between inferior phrenic artery and spinal cord blood supply- ing was the underlying mechanism inducing s