不同的栓塞材料经肝动脉栓塞治疗肝癌破裂出血的疗效对比分析
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摘要
目的探讨不同的栓塞材料治疗肝癌破裂出血的疗效对比。方法回顾分析近3年收治的57例,经导管肝动脉不同的栓塞材料栓塞治疗原发性肝癌破裂出血患者的临床资料,其中使用明胶海绵19例,使用Embosphere微球21例,使用明胶海绵+Embosphere微球17例,评价各组术后肝功能变化以及即时止血和再次出血率。结果明胶海绵组、微球组、明胶海绵+微球组之间术后肝功能指标差异无统计学意义(P>0.05);明胶海绵组栓塞术后1周内复发出血高于微球组、明胶海绵+微球组(P<0.05)。结论利用明胶海绵加Embosphere微球或者单独使用Embosphere微球经导管动脉栓塞术治疗肝癌破裂出血疗效确切,值得在临床上推广应用。
Objective To compare the therapeutic effects of different embolization materials in the treatment of hemorrhage caused by rupture of hepatocellular carcinoma(HCC). Methods The clinical data of 57 patients with rupture and hemorrhage of HCC, who were admitted to authors' hospital in past 3 years and received transcatheter hepatic arterial embolization(TAE) by using different embolization materials,were retrospectively analyzed. The embolization materials included gelatin sponge(n =19), Embosphere microspheres(n=21) and gelatin sponge+Embosphere microspheres(n=17). The postoperative liver function changes, instant hemostasis rate and rebleeding rate in each group were assessed. Results No statistically significant differences in postoperative liver function indexes existed between each other among the three groups(P>0.05). The rebleeding rate within one week after TAE in the gelatin sponge group was higher than that in the Embosphere microspheres group as well as in the gelatin sponge+Embosphere microspheres group(P <0.05). Conclusion In treating hemorrhage caused by HCC rupture, the use of gelatin sponge plus Embosphere microspheres or simple use of Embosphere microspheres as embolization materials has reliable curative effect, and it is worth popularizing in clinical practice.
Objective To compare the therapeutic effects of different embolization materials in the treatment of hemorrhage caused by rupture of hepatocellular carcinoma(HCC). Methods The clinical data of 57 patients with rupture and hemorrhage of HCC, who were admitted to authors' hospital in past 3 years and received transcatheter hepatic arterial embolization(TAE) by using different embolization materials,were retrospectively analyzed. The embolization materials included gelatin sponge(n =19), Embosphere microspheres(n=21) and gelatin sponge+Embosphere microspheres(n=17). The postoperative liver function changes, instant hemostasis rate and rebleeding rate in each group were assessed. Results No statistically significant differences in postoperative liver function indexes existed between each other among the three groups(P>0.05). The rebleeding rate within one week after TAE in the gelatin sponge group was higher than that in the Embosphere microspheres group as well as in the gelatin sponge+Embosphere microspheres group(P <0.05). Conclusion In treating hemorrhage caused by HCC rupture, the use of gelatin sponge plus Embosphere microspheres or simple use of Embosphere microspheres as embolization materials has reliable curative effect, and it is worth popularizing in clinical practice.
引文
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[4]申淑群,杨业发,葛乃建,等.肝癌破裂出血的介入与外科手术疗效评价[J].介入放射学杂志,2010,19:544-546.
[5]蔡晓东,谢承佳.原发性肝癌手术切除联合TACE与单纯手术切除疗效对比分析[J].安徽医药,2012,16:1623-1625.
[6]辜斌,魏小英,况圣佳,等.急诊肝动脉栓塞治疗肝癌破裂出血[J].介入放射学杂志,2007,16:489-490.
[7]Koch M,Stapleton CJ,Agarwalla PK,et al.157 open and endovascular treatment of spinal dural arteriovenous fistulae:a10-year experience[J].Neurosurgery,2016,63(Suppl 1):163
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[9]Cheong JY,Kong TW,Son JH,et al.Outcome of pelvic arterial embolization for postpartum hemorrhage:a retrospective review of 117 cases[J].Obstet Gynecol Sci,2014,57:17-27.
[2]Abdel Samie A,Otto G,Theilmann L.Acute haemoperitoneum due to spontaneous tumour rupture as first manifestation of hepatocellular carcinoma[J].Z Gastroenterol,2007,45:615-619.
[3]Fernandez-Ruiz M,Guerra-Vales JM,Llenas-Garcia J,et al.Hemoperitoenum as presentation of hepatocellular carcinoma:experience in three cases with spontaneous tumoral rupture and review of the literature[J].An Med Interna,2008,25:81-84.
[4]申淑群,杨业发,葛乃建,等.肝癌破裂出血的介入与外科手术疗效评价[J].介入放射学杂志,2010,19:544-546.
[5]蔡晓东,谢承佳.原发性肝癌手术切除联合TACE与单纯手术切除疗效对比分析[J].安徽医药,2012,16:1623-1625.
[6]辜斌,魏小英,况圣佳,等.急诊肝动脉栓塞治疗肝癌破裂出血[J].介入放射学杂志,2007,16:489-490.
[7]Koch M,Stapleton CJ,Agarwalla PK,et al.157 open and endovascular treatment of spinal dural arteriovenous fistulae:a10-year experience[J].Neurosurgery,2016,63(Suppl 1):163
[8]张德胜,于长鹿,何以一,等.急诊肝癌破裂出血的肝动脉栓塞[J].临床和实验医学杂志,2013,12:1412-1413.
[9]Cheong JY,Kong TW,Son JH,et al.Outcome of pelvic arterial embolization for postpartum hemorrhage:a retrospective review of 117 cases[J].Obstet Gynecol Sci,2014,57:17-27.