肝癌合并动门脉瘘的DSA表现和介入治疗方法

• 作 者: 陈燕浩 李家平 谭国胜 殷云志 向贤宏
• 机 构: 武汉市中心医院,中山大学第一附属医院,
• 出 处: 肿瘤学杂志
• 发表日期: 2010年01期
• 关键词: 动门脉瘘 DSA表现 介入治疗方法 动脉内化疗术 动脉内化疗栓塞 肝肿瘤 肝动脉灌注化疗 明胶海绵 门脉癌栓 transcatheter

[目的]探讨肝癌合并动门脉瘘(HAPVS)的DSA表现及介入治疗方法。[方法]对425例已证实为肝癌的患者先行DSA造影,再行肝动脉内化疗栓塞治疗。[结果]425例肝癌患者中有114例合并有不同程度HAPVS,所有动门脉瘘患者均行一次或多次经肝动脉灌注化疗(TAI)和/或经导管动脉内化疗栓塞(TACE)。[结论]DSA造影是肝癌合并HAPVS直观可靠的诊断方法。对于轻中度HAPVS用明胶海绵阻断瘘口血流后TACE安全有效,对重度流量大的HAPVS,则仅行TAI。

[Objective] To investigate the DSA manifestation and interventional therapy of hepatocellular carcinoma with arteriovenous fistula (HAPVS). [Method] The DSA angiography was performed on 425 cases of patients with confirmed hepatocellular carcinoma before embolization of hepatic arterial chemoembolization. [Results] Among 425 HCC patients, 114 patients had HAPVS complicated with different degrees of HAPVS. All patients with arteriosclerotic arterial fistula received one or more times of TAI and / or TACE. [Conclusion] DSA is an intuitive and reliable diagnostic method for HCC with HCC. For mild to moderate HAPVS with gelatin sponge blocking the blood flow of fistula after TACE safe and effective, heavy flow HAPVS, only TAI.