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选择性肝动脉导管栓塞联合CT引导下微波消融治疗肝血管瘤的效果分析
Clinical effect of selective transcatheter arterial embolization combined with CT-guided microwave ablation in treatment of hepatic hemangioma
文章发布日期:2018年06月07日  来源:  作者:鹿宁宁,王海燕,高文峰,等  点击次数:343次  下载次数:65次

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【摘要】:目的 探讨选择性肝动脉导管栓塞联合CT引导下微波消融治疗肝血管瘤的效果及安全性,为肝血管瘤治疗方法的选择提供参考。方法 回顾性分析2012年1月-2016年12月于首都医科大学附属北京估安医院接受选择性肝动脉栓塞联合CT引导下微波消融手术治疗的29例肝血管瘤患者的临床资料,观察消融相关并发症、完全消融率,血管瘤大小的变化,患者临床症状改善情况,评价该方案治疗效果及安全性。计量资料组间比较采用t检验。结果 29例患者共消融肝血管瘤病灶31个。术后11例患者出现消融相关并发症,其中单纯出现发热患者2例,腹痛患者3例,发热合并腹痛者2例,单纯出现血红蛋白尿者2例,血红蛋白尿合并肝包膜下少量出血者1例,胆汁瘤合并腹痛者1例。上述患者均经内科药物对症治疗后恢复正常。患者并发症发生率为37.93%(11/29),无严重并发症及死亡患者。术后3个月随访,消融治疗后所有患者临床症状完全消失。行增强CT或MRI检查,31个肝血管瘤病灶平均直径较术前明显缩小[(4.44±1.39)cm vs (6.58±1.25)cm,t=14.02,P<0.01],病灶平均残留率为(66.6±12.5)%。其中完全消融患者27例(93.1%),未完全消融2例(6.9%),此2例患者临床症状完全缓解,术后6个月再次随访肝血管瘤无进行性增大趋势,故未行重复消融治疗。结论 选择性肝动脉导管栓塞联合CT引导下微波消融手术治疗肝血管瘤,疗效好,安全性高,是一种值得推广的微创手术治疗方法。
【Abstract】:Objective To investigate the clinical effect and safety of selective transcatheter arterial embolization (TAE) combined with CT-guided microwave ablation in the treatment of hepatic hemangioma, and to provide a reference for the selection of treatment methods for hepatic hemangioma. Methods A retrospective analysis was performed for the clinical data of 29 patients with hepatic hemangioma who underwent selective TAE combined with CT-guided microwave ablation in Beijing YouAn hospital from January 2012 to December 2016. The complications of ablation, complete ablation rate, change in the size of hemangioma, and improvement in clinical symptoms were observed to evaluate the clinical effect and safety of this treatment regimen. The t-test was used for the comparison of continuous data between groups. Results A total of 29 patients with 31 lesions of hepatic hemangioma were treated. Eleven patients experienced the complications of ablation, among whom two experienced pyrexia alone, three experienced abdominal pain, two experienced pyrexia and abdominal pain, two experienced hemoglobinuria alone, one experienced hemoglobinuria and slight subcapsular bleeding, and one experienced bile tumor and abdominal pain, and these patients were cured after symptomatic treatment. The incidence rate of complications was 37.93% (11/29), and no patient experienced severe complications or death. The patients were followed up till three months after surgery, and the clinical symptoms completely disappeared after ablation. According to the results of contrast-enhanced computed tomography or magnetic resonance imaging, there was a significant reduction in the mean diameter of the 31 hepatic hemangiomas after surgery (4.44±1.39 cm vs 6.58±1.25 cm, t=14.02,P<0.01), and the mean residual rate of the lesions of hepatic hemangioma was (66.6±12.5)%. Of all patients, 27 (93.1%) achieved complete ablation and 2 (6.9%) had incomplete ablation, and since these two patients had complete remission of clinical symptoms and follow-up at 6 months after surgery showed no progressive enlargement of hepatic hemangioma, ablation was not performed again. Conclusion Selective TAE combined with CT-guided microwave ablation has a good clinical effect and high safety in the treatment of hepatic hemangioma, and therefore, it is a minimally invasive surgery holding promise for clinical application.
【关键字】:肝肿瘤;血管瘤;栓塞,治疗性;导管消融术;治疗结果
【Key words】:liver neoplasms; hemangioma; embolization, therapeutic; catheter ablation; treatment outcome
【引证本文】:LU NN, WANG HY, GAO WF, et al. Clinical effect of selective transcatheter arterial embolization combined with CT-guided microwave ablation in treatment of hepatic hemangioma[J]. J Clin Hepatol, 2018, 34(7): 1452-1455. (in Chinese)
鹿宁宁, 王海燕, 高文峰, 等. 选择性肝动脉导管栓塞联合CT引导下微波消融治疗肝血管瘤的效果分析[J]. 临床肝胆病杂志, 2018, 34(7): 1452-1455.

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