【作者】 游箭； 缪南东； 林杰； 邓进； 牟玮； 张琳； 朱结辉；

【Author】 You Jian Miao Nan-Dong Lin Jie Deng Jin Mu Wei Zhang Lin Zhu Jie-Hui Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China; Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China

【机构】 川北医学院附属医院放射科； 第三军医大学西南医院放射科；

【摘要】 目的:探讨肝癌介入治疗中的血管损伤的原因及其预防、处理措施。方法:550例肝癌患者行TACE,发现14 例发生血管损伤,其中男性11例,女性3例,年龄39岁₆1 岁。结果:发生动脉夹层6例,部位为髂动脉2例、腹主动脉 1例和肝动脉3例,主要是导丝导管对血管的损伤,发生在老年有动脉硬化和血管走向扭曲的患者,发生肝动脉痉挛5例, 由于导管、导丝、化疗药物、碘油等对肝动脉的刺激,发生肝动脉闭塞2例,肝动脉的损伤与手术时导管导丝的机械性刺激,化疗药物和碘油、明胶海绵的刺激有关。发生肝动脉假性动脉瘤1例,亦与导管导丝的操作有关。有3例因肝功能受损于2周内死亡。结论:肝癌介入治疗中的血管损伤是其少见的并发症,直接影响治疗计划和治疗结果。重视预防和及时处理血管损伤对肝癌患者的进一步治疗有重要意义。更多还原

【Abstract】 Objective: To explore the results of vascular injure during interventional therapy of liver cancer, as well as prevention and management.Methods: In 550 liver cancer patients experiencing transcatheter hepatic arterial chemoembolization (TACE), 14 cases resulted in vascular injure: male 11 cases, female 3 cases, aged between 39 to 61 years old. Results: 6 cases resulted in arterial dissection, 2 cases of them lie in iliac artery, 1 case abdominal aort and 3 cases hepatic artery, the main result is seen in aged patients with arteriosclerosis and arterial distortion; 5 cases resulted in spasm of hepatic artery, resulted from harmful simulation of catheter, guide-wire, chemical drug, Lipiodol, etc; 2 cases resulted in occlusion of hepatic artery, simulation of catheter, guide-wire, chemical drug, Lipiodol, gelfoam, etc; 1 case resulted in pseudoaneurysm, also resulted from management of catheter and guide-wire. There were 3 cases died in lower level of hepatic function within 2 weeks. Conclusion: The vascular injure of interventional treatment of liver cancer is barely seen as complication, which directly affect the therapeutic plan and therapeutic result of liver cancer. Therefore, it is important to put great emphasis on prevention and immediate treatment towards continual treatments in patients of liver cancer.更多还原