肝外供血动脉栓塞在巨块型肝癌治疗中的价值

目的探讨经导管肝外供血动脉栓塞在治疗巨块型肝癌中的价值。方法对35例巨块型肝癌,首次行经导管肝动脉化疗栓塞术（TACE）,第2次及其后在肝动脉TACE基础上加行经右侧胸廓内动脉、右侧肋间动脉侧支供血动脉栓塞术。结果本组35例巨块型肝癌患者,发现肝外侧支49支,对46支使用微导管进行栓塞治疗,3支行超选择灌注化疗。初次TACE治疗时肝外血供多有膈下动脉参与,治疗过程中,随着肿瘤的增大或肝动脉的闭塞,胸廓内动脉、肋间动脉、胰十二支肠动脉弓等血管有可能参与。结论对肝外侧支血管应用微导管超选择栓塞或灌注化疗均能加强TACE在巨块型肝癌治疗中的作用,提高患者带瘤生存期。

Extra-hepatic artery embolization in the treatment of giant hepatocellular carcinoma

Objective To discuss the value of extra-hepatic artery embolization in the treatment of giant hepatocellular carcinoma (HCC). Methods Thirty-five patients with giant HCC were enrolled in this study. Angiography was performed on celiac artery at the 1st time of transcatheter arterial chemoembolization (TACE), and on superior mesenteric artery and diaphragmatic artery right internal thoracic artery, right intercostal artery. during the 2nd and next TACEs to explore extra-hepatic blood supply of the tumors. Results In all 35 patients, 49 extra-hepatic arterial branches were found, and 46 were treated with chemoembolotherapy, 3 with super selective chemotherapy. Diaphragmatic artery often served as extra-hepatic arterial blood supply, and then internal thoracic artery, intercostal artery, etc. Conclusion Super selective chemoembolization or chemothrephy of extra-hepatic blood supply arteries can improve the therapeutic effect of TACE for giant HCC.