| 黄洪华,李拥军,徐爱兵.肝癌合并肝动—静脉瘘的介入栓塞处理策略及疗效观察[J].肿瘤学杂志,2013,19(7):509-513. |
| 肝癌合并肝动—静脉瘘的介入栓塞处理策略及疗效观察 |
| Strategy and Clinical Effect of Interventional Chemoembolization on the Treatment for Hepatocelluar Carcinoma Complicated with Hepatic Arteriovenous Shunting |
| 投稿时间：2012-10-19 |
| DOI：10.11735/j.issn.1671-170X.2013.07.B002 |
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| 中文关键词: 肝肿瘤 动静脉瘘 栓塞，治疗性 介入疗法 |
| 英文关键词:hepatic neoplasms arteriovenous shunting embolization,therapeutic interventional therapy |
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| 中文摘要: |
| 摘 要：［目的］ 探讨原发性肝癌合并肝动—静脉瘘的介入栓塞治疗方法及疗效。［方法］ 回顾性分析32 例经DSA检查确诊为原发性肝癌伴有肝动—静脉瘘患者的临床资料。根据瘘口部位、大小及肿瘤染色情况，采用明胶海绵和(或)无水酒精和(或)聚乙烯醇(PVA)封堵瘘口并行碘油化疗栓塞，观察其疗效。［结果］ 28 例完成碘油化疗栓塞(TACE)，其中23 例一次封堵成功，5 例因有多发瘘口，反复栓塞，仍有少量瘘口不能完全封堵。4 例因瘘口大，同时有门静脉主干瘘，仅行化疗灌注(TAI)。在后续介入治疗中发现，瘘口封堵成功者，9 例瘘口重新开通或有新的瘘口出现，3 例再次封堵瘘口后成功。术后3个月、6个月、12个月生存率分别为93.75%、78.13%、37.50%。［结论］ 对于原发性肝癌合并肝动—静脉瘘，术中有效的封堵瘘口能为肿瘤的碘化油栓塞提供良好的治疗环境，可提高介入治疗的疗效，延长患者的生存时间。 |
| 英文摘要: |
| Abstract:［Purpose］ To explore the strategy and clinical effect of interventional chemoembolization on treatment for primary hepatocelluar carcinoma(HCC) complicated with different types of hepatic arteriovenous shunting(HAVS). ［Methods］ The clinical data of 32 cases with HCC complicated with HAVS were analyzed retrospectively. All patients were treated with lipiodol chemoembolization，and according to the position and size of shunt and tumor staining，shunts were embolized by gelfoam and(or) anhydrous alcohol and(or) polyvinyl alcohol(PVA).The clinical response were observed.［Results］ Twenty-eight cases were treated with transcatheter arterial chemoembolization(TACE)，4 cases were treated with TAI. Twenty-three shunts were completely closed successfully，5 shunts were partly closed and 4 shunts were not closed. The shunts reopened or new shunt emerged in later therapy in 9 patients，and 3 of them were closed after second embolization. The 3 months，6 months and 1 year survival rates were 93.75%，78.13%，37.50% respectively.［Conclusion］ Embolizing the shunt of HAVS in patients with HCC is effective. It can afford good therapeutic circumstances for embolization with lipoidol，improve the therapeutic effect and elongate the survival time. |
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