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目的:探讨经肝动脉导管注射明胶海绵碘化油乳剂治疗肝癌合并严重动静脉瘘的可行性及临床应用价值。方法:对38例肝癌动静脉瘘患者血管分别行超选择插管注射明胶海绵碘化油乳剂,造影观察动静脉瘘的栓塞率,血管再通率,副作用,并发症及生存率等指标。结果:38例肝癌动静脉瘘患者经肝动脉导管注入明胶海绵碘化油乳剂约2～10mL栓塞,栓塞后造影显示闭塞率为94.7%(36/38),4周后造影显示动静脉瘘再通率为5.56%(2/36),未见确切不良反应,肿瘤碘化油乳剂沉积好,患者6月生存率为94.7%(36/38),12月生存率为60.5%(23/38),24月生存率为21.1%(8/38)。结论:经肝动脉导管注射碘化油乳剂治疗肝癌动静脉瘘安全可靠,对瘘口要求不高,栓塞率高,再通率低,肿瘤的栓塞治疗效果好。
Objective: To investigate the feasibility and clinical value of transcatheter hepatic artery catheter injection of gelatin sponge iodized oil emulsion in the treatment of hepatocellular carcinoma with severe arteriovenous fistula. Methods: Thirty-eight patients with arteriovenous fistula of liver cancer underwent ultra-selective intubation with gelatin sponge iodized oil emulsion. The embolization rate, recanalization rate, side effects, complications and survival rate of arteriovenous fistula were observed. Results: Thirty-eight cases of hepatic arteriovenous fistula were injected with gelatin sponge iodized oil emulsion about 2 ~ 10 mL via the hepatic artery catheter. The embolization rate after embolization was 94.7% (36/38). Four weeks later, angiography showed arteriovenous fistula The overall survival rate was 94.7% (36/38) in June, and 60.5% in December (23/38), with a median pass rate of 5.56% (2/36). No definite adverse reactions were observed. ). The 24-month survival rate was 21.1% (8/38). Conclusion: The hepatic arterial catheter injection of iodized oil emulsion for the treatment of hepatic arteriovenous fistula is safe and reliable, less demanding on the fistula, high embolic rate, low recurrence rate and good embolization effect.