中晚期肝癌肝外供血分析及临床介入治疗

目的探讨肝癌的肝外动脉供血规律及介入治疗。方法92例肝癌患者发现肝外供血动脉105条，分别超选择插管行化疗栓塞。结果中晚期肝癌肝外动脉来源类型分别源于肠系膜上动脉（33．33％）、右膈下动脉（17．14％）、胃十二指肠动脉（14．29％）、左膈下动脉（7．62％）、胃左动脉（6．67％）、右肋间动脉（6．67％）、右肾上腺动脉（4．76％）、脾动脉（4．76％）、右腰动脉（2．86％）和右胸廓内动脉（1．90％）。形成肝外动脉的影响因素较多，包括化疗栓塞的次数、肿瘤在肝内的部位、肿瘤的直径和操作方法。结论肝癌有丰富的肝外动脉供血，对肝外动脉供血支超选择性栓塞治疗，对提高中晚期肝癌患者介入治疗疗效具有重要的临床意义。

Clinical analysis of extrahepatic arterial blood supply of primary hepatic carcinoma and interventional therapy

Objective To study the pattern of extrahepatic artery supply to primary hepatic carcinoma(PHC) and its intervertional therapy.Methods A total of 105 collateral arterial pathways were found in 92 PHC patients,and superselective catherization and transcatheter arterial chemoembolization(TACE) to extrahepatic artery were performed.Results Extrahepatic artery supply to PHC originated from superior mesenterie artery(33.33%),right inferior phrenic artery(17.14%),gastroduodenal artery(14.29%),left inferior phrenic artery(7.62%),left gastric artery(6.67%),right intercostals artery(6.67%),right adrenal artery(4.76%),splenic artery(4.76%),right lumbar artery(2.86%) and right internal mammary artery(1.90%),respectively.The influence factors of formation of extrahepatic artery supply to hepatic carcinoma included the times of repeated chemoembolization,the location of tumors in liver,the tumor size and the type of chemoembolization.Conclusion Ample extrahepatic arterial blood supply is found in PHC.Superselective TACE of extrahepatic artery has very important clinical significance for better efficacy of PHC patients.