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目的 研究肝—胃动脉 (hepatogastricartery ,HGA)的解剖特征及其对肝癌患者动脉内化疗栓塞术 (transcatheterarterialchemoembolization ,TACE)后胃肠道并发症的影响。方法 回顾分析 10 0 0例肝动脉血管造影资料 ,将由肝固有动脉及其远端各级肝动脉发出的主要供应胃及十二指肠的变异血管命名为肝—胃动脉 ,研究其起源、走行、分支分布等解剖特征。分别统计分析 3 4例(共行 42次TACE)存在HGA(研究组 )及 3 2例 (共行 5 6次TACE)无HGA(对照组 )的肝癌患者TACE术后胃肠道合并症的发生率 ,比较两组间胃肠道合并症有无差异。研究组中 42次TACE ,其中 18次TACE在动脉注射栓塞剂前 ,行超选择性插管使导管尖端位于HGA开口的远端 (相对安全组 ) ;2 4次TACE导管尖端未避开HGA即行栓塞治疗 (危险组 ) ,比较两组间胃肠道合并症有无差异。结果 10 0 0例肝动脉造影中 ,744例存在HGA ,占 74%。研究组中TACE术后胃肠道合并症的发生率及其严重程度明显高于对照组(Ρ =0 .0 0 4) ;危险组中胃肠道合并症的发生率及其严重程度明显高于相对安全组 (Ρ =0 .0 0 0 )。结论 HGA是一种常见的血管变异 ,TACE时栓塞剂误栓HGA可引起术后不同程度胃肠道合并症的发生 ,行超选择插管避开HGA开口再行栓塞治疗 ,可有效地预防术后胃?
Objective To study the anatomic characteristics of hepatogastricartery (HGA) and its effect on gastrointestinal complications after transcatheter arterial embolization (TACE) in patients with liver cancer. Methods A retrospective analysis of 100 cases of hepatic artery angiography data, will be from the hepatic artery and its distal hepatic artery at all levels of the main supply of gastric and duodenal varietal vascular named hepatic - gastric artery, the study of its origin, walking , Branch distribution and other anatomical features. The incidence of gastrointestinal complications after TACE was retrospectively analyzed in 34 HCC patients (study group) and 32 HCC patients (56 patients in total) without HGA (control group) Rate, compare the two groups of gastrointestinal complications with or without differences. Forty-two TACEs were included in the study group. TACE was performed 18 times before arterial injection of embolization agent. The catheter tip was located at the distal end of the HGA opening (relative safety group). Twenty-four TACE catheter tips did not avoid HGA Embolization treatment (risk group), the difference between the two groups in gastrointestinal complications. Results Among the 100 cases of hepatic arteriography, 744 cases had HGA, accounting for 74%. The incidence and severity of gastrointestinal complications after TACE in the study group were significantly higher than those in the control group (P = 0.040). The incidence and severity of gastrointestinal complications in the risk group were significantly higher In the relative safety group (P = 0. 0 0 0). Conclusions HGA is a common vascular variation. TACE may cause postoperative complications of gastrointestinal complications due to HGA embolism. Cholecystectomy may be avoided by re-embolization instead of HGA. After the stomach?