同轴插管经皮远端硬化栓塞治疗精索静脉曲张

为了减少精索静脉曲张经皮硬化栓塞术中的复发因素，提高硬化剂治疗的效果，从１９９１年３月至１９９５年６月使用同轴插管方法，进行精索静脉远端主干和近端侧支血管的硬化栓塞，共治疗左侧精索静脉曲张２３例，精索静脉近端插管全部成功，远端插管的成功率为７８．０％，栓塞后的显效率为９５．６％，无并发症。平均随访１４个月未见复发。认为该方法可准确、安全、高效地进行精索静脉曲张的硬化治疗。     

NT－海球栓静脉栓塞治疗精索静脉曲张

作者采用７枚ＮＴ－海球栓，分别栓塞了７根犬静脉。１５～２５天后病理解剖发现栓器与靶静脉内膜牢固性相嵌，无回心性脱落与误栓，栓器的内在空间与血管内膜之间，为致密性纤维组织。；临床治疗精索静脉曲张１０例，栓后１～３天，曲张的精索静脉消失。栓后３０天，精索静脉萎陷，原有症状消失。经１．５～２．３年的随访，未见复发。作者认为，应用ＮＴ－海球栓治疗精索静脉曲张是一种简便、有效的方法。     

介入栓塞治疗精索静脉曲张的临床体会

目的观察经导管精索内静脉钢圈栓塞治疗精索静脉曲张的疗效。方法对16例精索静脉曲张患者进行经导管栓塞治疗,分析其疗效。结果16例患者经导管栓塞治疗后阴囊内容物缩小,阴囊坠胀感及疼痛等症状有不同程度的改善,精液质量明显提高,未出现严重的并发症。结论导管法钢圈栓塞治疗精索静脉曲张简单、经济、疗效满意,值得推广。     

重度精索静脉曲张治疗体会

精索静脉曲张系指因精索静脉的血流淤积而导致精索的蔓状静脉丛扩张、伸长、迂曲改变。其中症状明显或已引起睾丸萎缩、精液质量下降及造成不育者需要手术治疗，现治疗多以精索内静脉高位结扎术和腹腔镜手术为主，但重度精索静脉曲张症状明显者因阴囊内曲张静脉团未消除，故术后症状常不能消失。1999年8月～2006年8月本院对85例重度精索静脉曲张患者进行了临床研究，现报告如下。     

NT-海球栓栓塞治疗精索静脉曲张疗效观察

应用NT－海球栓栓塞治疗精索静脉曲张30例。结果栓塞后1～3d，精索静脉曲张全部消失。随访1．5～4．5年，精液质量明显改善。认为NT－海球栓栓塞治疗精索静脉曲张是一种安全、简便、有效的方法。     

重度精索静脉曲张治疗体会

精索静脉曲张系指因精索静脉的血流淤积而导致精索的蔓状静脉丛扩张、伸长、迂曲改变.其中症状明显或已引起睾丸萎缩、精液质量下降及造成不育者需要手术治疗,现治疗多以精索内静脉高位结扎术和腹腔镜手术为主,但重度精索静脉曲张症状明显者因阴囊内曲张静脉团未消除,故术后症状常不能消失.1999年8月～2006年8月本院对85例重度精索静脉曲张患者进行了临床研究,现报告如下.     

精索静脉曲张手术结扎与血管栓塞治疗男性不育的疗效分析

本文为了对比精索静脉曲张手术结扎与血管栓塞器治疗男性不育的疗效。随机将４６例患者分成手术结扎组和血管栓塞组行对照分析。手术组２５例，血管栓塞组２１例，随访６个月至１年半。结果表明：两组病例的精子数目和精子活动率均有明显增加，而精子形态依然无变化，两种疗法比较无显著性差异（Ｐ〉０．０５）。但海螺状或螺旋球形血管栓塞器（ＮＴ－海球栓）栓塞治疗的优点为缩短住院的时间，可在门诊进行，是目前治疗精索静脉曲张     

骨肿瘤的经导管动脉栓塞治疗

研究和评估经导管动脉栓塞术治疗骨肿瘤的价值、作用。对１７例丰富血供性骨肿瘤用明胶海绵进行选择性动脉栓塞，栓塞后３天内进行手术；对７例不宜手术的骨肿瘤用明胶海绵混合抗癌药后进行姑息性栓塞治疗。１６例术前栓塞后１５例肿块被顺利切除，术中出血量大大减少，平均为９４７ｍｌ；７例姑息性栓塞患者疼痛得到了不同程度的缓解，肿块明显缩小。无１例发生严重并发症。经导管动脉栓塞术为某些骨肿瘤十分重要而有效的治疗方法。     

Transcatheter Arterial Embolization in the Treatment of Extensive Maxillofacial Hemangioma in Children

Infantile hemangioma frequently occurs in the maxillofacial region as an extensive mass involving many vital structures. As such, many children are found to have an unresectable hemangioma at the initial diagnosis. In the present study transcatheter arterial embolization (TAE) alone or in combination with surgery and local injection of bleomycin A has been attempted to improve the treatment of these lesions. The results of evaluating the effectiveness and therapeutic role of TAE in these extensive maxillofacial hemangiomas in children are presented. We retrospectively analyzed the records of 17 children with maxillofacial hemangioma treated between 1997 and 2004. Altogether, 17 patients (11 boys, 6 girls) were diagnosed as having an extensive maxillofacial hemangioma based on its clinical manifestation, color Doppler ultrasonography, and sometimes computed tomography. They underwent selective TAE alone or TAE followed by surgical excision. For the children with Kasabach-Merritt syndrome, systemic corticosteroid therapy was administered first. All the children had an excellent response after TAE treatment without obvious complications, and the size of the hemangioma body markedly decreased. Local injection of bleomycin A was then undertaken in four children and surgical removal in five. All the children achieved successful disappearance of the hemangioma, with no recurrence during the follow-up period of 5 to 86 months. TAE is thus a reliable and effective therapeutic choice for extensive maxillofacial hemangioma in children, alone or as a preoperative adjunctive measure. It improves the feasibility of complete resection and effects the disappearance of these potentially dangerous bulky tumors with little bleeding and few complications.     

靶血管栓塞后手术治疗骶骨肿瘤

目的：研究和评估经导管动脉栓塞后手术治疗骶骨肿瘤的价值和作用。方法：对２１例骶骨肿瘤用明胶海绵进行选择性动脉栓塞，栓塞后平均１．８天手术。结果：肿瘤均被顺利切除；术中出血大大减少，平均出血量为８９０ｍｌ。１６例获平均１８个月随访，未见局部复发。结论：靶血管栓塞后手术治疗骶骨肿瘤，可有效地减少术中出血，降低手术的危险性，增加肿瘤切除率和彻底切除的可能性，是十分有效的方法。     

Transcatheter Embolization for the Treatment of Misperfusion After Hepatic Artery Chemoinfusion Pump Implantation

Background: The use of surgically implanted chemoinfusion pumps for the treatment of hepatic metastases from colorectal carcinoma can be complicated by intra- or extrahepatic misperfusion. This may result in suboptimal tumor exposure to the chemotherapeutic agent and injury to other gastrointestinal organs. Misperfusion can be managed by selective arterial transcatheter embolization.Methods: Between 1989 and 1996, 16 patients with liver metastases from colorectal carcinoma and with hepatic artery chemoinfusion pump misperfusion were treated using transcatheter coil embolization. Six female and 10 male patients (age range, 34–84 years; median, 51.5 years) were identified by retrospective review of the records of the Department of Interventional Radiology. After pump placement, abnormal liver perfusion scan or methylene blue endoscopy study results prompted angiography with coil embolization. After embolization, the imaging studies were repeated and patients were monitored in the Oncology Clinic.Results: Eight patients exhibited intrahepatic misperfusion (group 1) and eight extrahepatic misperfusion (group 2). Coil embolization was immediately successful in 100% of patients in group 1, with restoration of normal hepatic perfusion, and in 75% in group 2. There were no immediate procedure-related complications. Follow-up periods ranged from 1 to 23 months (median, 13.5 months). Embolization was unsuccessful for two patients (in group 2), who tolerated a modified chemotherapeutic regimen, with follow-up periods of 18.5 and 22 months.Conclusions: Transcatheter coil embolization is the therapy of choice for the management of hepatic artery chemoinfusion pump misperfusion. It is rapid, effective, and well tolerated by patients and obviates the need for additional surgical intervention.     

经导管子宫动脉栓塞术治疗子宫肌瘤

目的探讨经导管子宫动脉栓塞术(transcatheter uterine artery embolization,TUAE)治疗子宫肌瘤的临床应用价值。方法34例子宫肌瘤患者采用平阳霉素碘油乳剂加明胶海绵颗粒行TU-AE。结果术后3月、6月(34例)及1年(22例)随访复查,患者月经量及月经周期恢复正常,贫血改善,术后子宫肌瘤均有不同程度缩小,3个月后复查肌瘤缩小到原来的62%,6个月后缩小到原来的42%,1年后缩小到原来的10%。结论TUAE治疗子宫肌瘤安全、有效。     

腹腔镜精索静脉结扎术38例报告

目的 探讨腹腔镜技术在精索静脉曲张治疗中的作用及注意事项。方法 应用腹腔镜施行精索静脉高位结扎术38例。结果 手术均获成功,平均手术时间32(18～45)分钟;术后次日下床,2～3天出院;随访3～6月,曲张静脉均消失,无睾丸萎缩等并发症发生;16例伴男性不育症9例精液质量有改善。结论 腹腔镜精索静脉结扎术效果可靠、对机体干扰轻、并发症少、恢复快,可同时施行双侧手术。     

经肝动脉栓塞治疗肝脏海绵状血管瘤的临床应用价值

目的评价平阳霉素碘油乳剂经选择性肝动脉栓塞治疗巨大肝海绵状血管瘤的临床应用及疗效。方法对35例有症状的巨大肝海绵状血管瘤患者采用Seldinger技术,经皮股动脉穿刺行肝动脉插管注入平阳霉素碘化油乳剂栓塞硬化肝血管瘤,并用明胶海绵颗粒栓塞瘤体供血动脉。栓塞术后定期随访观察血管瘤缩小、临床症状缓解及并发症情况。结果栓塞治疗后肿瘤进行性缩小,术后第3、6、9、12个月复查,肿瘤平均缩小程度分别为26.6%、41.5%、58.3%、68.7%;其中5例肝血管瘤分别于第12个月和第18个月复查CT提示血管瘤瘤体基本消失;所有患者临床症状明显减轻或消失,无严重并发症发生。结论平阳霉素碘油乳剂栓塞治疗肝海绵状血管瘤安全有效、并发症少,具有重要的临床应用价值。     

骶骨脊索瘤靶血管栓塞手术治疗及并发症分析

目的总结分析靶血管栓塞后手术治疗骶骨脊索瘤的疗效及并发症防治。方法回顾性分析我院1996年1月至2007年1月22例骶骨脊索瘤患者。本组均采用DSA下经导管栓塞双侧髂内动脉，骶正中动脉及肿瘤其他靶血管，栓塞后行后路手术治疗。随访其疗效并初步探讨并发症的发生及防治措施。结果所有患者均顺利完成手术，无术中休克或死亡病例。术中平均出血1206mL（200-3200mL），手术近期并发症有切口感染1例，切口延迟愈合3例，切口皮缘坏死5例，9例出现小便功能改变，8例出现大便功能障碍。平均随访36个月（9～80个月），死亡1例，复发9例，无转移病例。结论术前经DSA下靶血管栓塞后行单纯后路手术可以完全切除骶骨脊索瘤，术中出血较少，相应的防治措施可以明显减少并发症的发生。