彩色多普勒超声在选择性门静脉联合肝动脉栓塞治疗中晚？…

目的 探讨彩色多普勒超声对经皮肝选择性门静脉栓塞化疗（ＳＰＶＥ）联合肝动脉栓塞（ＴＡＥ）治疗中晚期肝癌的应用价值。方法 彩超引导６５例不能手术的中晚期肝癌在ＴＡＥ基础上行ＳＰＶＥ术,同时一组与单纯ＴＡＥ对照组治疗前后的肿瘤血供变化、声像图特征及与临床疗效的关系。结果 ①本组肿瘤血供本组与单纯ＴＡＥ对照组治疗前后的肿瘤血供消失和率９２．３％,其中动脉血流消失和减少率８９．２％,门静脉血流消失和减少率     

应用彩超确立肝癌血供特征建立不同个体化治疗模式

目的应用彩超确立肝癌血供特征建立不同个体化治疗模式。方法对318例肝癌患者根据彩超确立肝癌及门静脉癌栓的血供特点并将其分型;通过对多电极射频治疗技术(RF)、无水乙醇瘤内注射技术(PEI)、肝动脉化疗栓塞技术(TACE)、门静脉栓塞化疗技术(SPVE)的对比研究,建立不同的个体化联合治疗模式;同时观察治疗组与单纯TACE对照组治疗前后的肿瘤血供变化,声像图特征等与临床疗效的关系。结果不同模式治疗组术后瘤周及瘤内血流信号完全消失率、肿瘤缩小率、AFP转阴率、术后随访1年、3年生存率均远高于对照组。结论应用彩超确立肝癌的血供分型,建立独特的个体化联合治疗模式是治疗肝癌的有效方法,并为观察治疗肝癌前后血供变化、声像图特征与临床疗效的关系提供客观依据。     

220例肝癌患者肝动脉栓塞术前后肝动脉血流动力学的超声影像分析

应用彩色多普勒超声((DH)对220例原发性肝癌(HOC)患肝动脉化疗及栓塞术(TAE)前后肿瘤血供．肝动脉血流动力学改变进行了观察。结果表明；(①肝癌主要由肝动脉供血，少部分由门静脉供给；②TAE后肿瘤内部及周边动脉血流明显减少（P<0.05)；③肝动脉收缩期最大流速(Vmax)、舒张期最小流速(Vain)均明显下降(P<0．005)．阻力指数(RI)和肝动脉直张改变不明显（P>0.05)；④TAE后瘤体明显减小（P<0.001)。认为在行TAE前后．应用CEFI对肿癌血供、肝动脉血流动力学进行观察分析．可给TAE预后提供重要指标，给重复治疗提供依据。CDFI是目前肝癌肝动脉栓塞治疗前后最好的影像学检查方治。     

彩色多普勒超声对原发性肝癌肝动脉栓塞前后肝血管的血流动力学观察

目的观察原发性肝癌肝动脉栓塞前后肝血管的血流动力学改变。方法应用彩色多普勒超声(CDFI)对60例原发性肝癌患者行肝动脉栓塞(TAE)治疗前后肝血管的血流动力学变化进行研究。结果(1)TAE后肝动脉血流减少(P<0.05),而阻力指数(RI)和肝动脉内径改变不明显(P>0.05);(2)门静脉血流于TAE后增加(P<0.05),门静脉内径无明显变化(P>0.05);(3)TAE后瘤体明显缩小,瘤体血供减少(P<0.05);(4)肝静脉的血流治疗前后无明显改变(P>0.05)。结论CDFI是观察原发性肝癌肝动脉栓塞治疗前后较好的影像学检查方法。     

彩色多普勒超声对原发性肝癌肝动脉栓塞前后血流动力学改变的研究

目的:观察原发性肝癌肝动脉栓塞前后肝血管的血流动力学改变。方法:应用彩色多普勒超声(CDFI)对60例原发性肝癌患者行肝动脉栓塞(TAE)治疗前后肝血管的血流动力学变化进行研究。结果:(1)TAE后肝动脉血流减少(P<0.05),而阻力指数(RI)和肝动脉内径改变不明显(P>0.05);(2)门静脉血流于TAE后增加(P<0.05),门静脉内径无明显变化(P>0.05);(3)TAE后瘤体明显缩小,瘤体血供减少(P<0.05);(4)肝静脉的血流治疗前后无明显改变(P>0.05)。结论:CDFI是观察原发性肝癌肝动脉栓塞治疗前后最好的影像学检查方法。     

CDFI对肝癌肝动脉栓塞术前后肝动脉血流动力学的观察

本文应用彩色多普勒超声（CDFI）对22例原发性肝细胞癌（HCC）患者肝动脉化疗及栓塞术（TAE）前后肿瘤的血供情况、肝动脉血流动力学的改变进行了观察。结果表明：①肝癌主要由肝动脉供血，少部分由门静脉供给；②TAE后肿瘤内部及周边动脉血流明显减少（P＜0．05）；③肝动脉收缩期最大流速（Vmax）、舒张期最少流速（Vmin）均明显下降（P＜0．05），而阻力指数（RI）和肝动脉直径改变不明显（P＞0．05）；④TAE后瘤体也明显减小（P＜0．001）。本文认为在行TAE前后，应用CDFI对肿瘤血供、肝动脉血流动力学改变进行观察分析，可以给TAE的预后提供重要指标，给下步重复治疗提供依据。所以CDFI是目前肝癌肝动脉栓塞治疗前后最好的影像学检查方法。     

超声引导射频治疗加无水酒精注射联合肝动脉栓塞治疗肝癌的临床研究

目的：探讨超声引导多方法联合动脉栓塞（TAE）治疗肝癌的临床价值。方法：在超声引导下对198例肝癌患者行多电极射频治疗加无水酒精瘤内注射联合TAE治疗，同时观察治疗组与单纯TAE对照组治疗前后的肿瘤血供变化，声像图特征等与临床疗效的关系。结果：治疗组术后瘤周及瘤内血流信号完全消失和减少率92．93％；肿瘤缩小率91．93％，AFP转阴率82．54％，术后随访年，2年累计生存率分别为87．31％、78．68％，远高于单纯TAE组的59．46％和31．53％。结论：超声引导多方法联合TAE技术是治疗肝癌的有效方法，超声为观察治疗前后肝癌血供状态，声像图变化及与临床疗效关系提供主要依据，对指导治疗，判定疗效有着重要意义。     

彩色多普勒超声在肝癌肝动脉和门静脉双重栓塞治疗中的应用价值

本文应用彩色多普勒血流显像观察肝癌肝动脉栓塞（ＴＡＥ）及肝动脉和门静脉双重栓塞（ＴＡＥ＋ＰＶＥ）治疗前后肿瘤血供和声像图的变化以及二者之间的关系。结果显示ＴＡＥ后，肿瘤门静脉供血从２０．９％增加到５５．６％。在ＴＡＥ基础上行ＰＶＥ治疗，使肿瘤动脉供血和门静脉供血均明显减少。肝癌化疗栓塞后肿瘤缩小程度与血供减少程度密切相关。经双重栓塞治疗的肝癌患者临床预后优于单纯经ＴＡＥ治疗者。结果表明彩色多普勒超声在指导临床介入件治疗药物用量和评价介入性治疗效果起重要作用。     

肝段动脉化疗栓塞治疗肝癌

经导管肝动脉栓塞术(TAE)巳广泛地用于肝癌的非手术治疗,常规TAE不能造成肿瘤组织的完全坏死,反复TAE治疗也会给肝功能带来损害。肝段动脉化疗栓塞是在TAE基础上发展起来的新技术.众所周知,肝癌除主要地接受肝动脉分支供血外,部分地接受门静脉分支和胆管周围血管丛的供养,肝段动脉化疗栓塞的目的就是同时封闭肿瘤组织周围各种供养血管。我们报告了12例肝癌患者接受肝段动脉化疗栓塞的初步经验,重点地对插管技术、适应症和应用理论进行了讨论。     

肝母细胞瘤肝动脉栓塞化疗前后彩超观察血流改变及临床意义

目的：研究肝母细胞瘤肝动脉栓塞化疗前后血流动力学改变及血流动力学变化对栓塞化疗效果的影响。方法：运用彩色多普勒B超监测4例巨大肝母细胞瘤患儿在介入治疗前，介入治疗后1周，2周，3周，4周时肝脏及瘤体的血流动力学变化和肿瘤大小改变。结果：介入治疗前肝母细胞瘤全肝供血增加，介入治疗后近期，表现为肝固有动脉血流量骤减和门静脉血流量代偿性增加，随着介入治疗后时间的延长，肝固有动脉血流量进一步降低，而门静脉血流量则逐渐恢复到治疗前水平，肝脏和肿瘤的血供均明显减少，这一变化与肿瘤的缩小呈正比例，当介入治疗后时间超过3周时，肝脏和肿瘤的血供又有不同程度增加，提示再次介入治疗的必要。结论：彩色多普勒超声能准确反映肝母细胞瘤动脉栓塞化疗前后的血供变化，肝母细胞瘤介入治疗前后血流动力学改变的监测对判断介入治疗的预后以及选择再次介入治疗或手术治疗的时机具有重要的临床意义。     

经导管肝动脉化疗栓塞术后栓塞综合征的研究现状及护理进展

栓塞综合征(PES)是经导管肝动脉化疗栓塞(TACE)术后患者常见并发症,影响患者预后。本文对PES的研究现状、治疗及护理等方面展开综述,以期为临床医护人员认识及处理PES提供理论依据。     

Atheromatous embolization

Atheromatous emboli occur spontaneously or may be secondary to surgery or trauma. Thurlbeck and Castleman found a 77% incidence of atheromatous emboli to the kidney following the surgical repair of abdominal aortic aneurysms. Atheromatous debris may be dislodged following aortography, renal arteriography, and left heart catheterization via the right femoral artery. External trauma, including hip fracture, external cardiac message, and blunt abdominal trauma have initiated peripheral atheromatous embolization. The incidence of this phenomenon may be higher than documented in the literature, since it is difficult to establish the diagnosis prior to death. Atheromatous emboli should be suspected clinically in elderly patients with sudden onset of pain and ischemia of the lower extremities or unexplained renal failure. At the present time, multiple atheromatous emboli may be treated symptomatically only. Muscle biopsy, retinal examination, and kidney biopsy may be used to differentiate atheromatous embolization from other clinical entities.     

Vascular embolization

Summary

Vascular embolization has been shown to be of great value in a variety of clinical situations, and in many of these itshould be the procedure of first choice, either prior to, or as an alternative to, more conventional surgical or medical therapy. Clinicians should be aware of the numerous indications for this technique and the often excellent results that are obtained. This article describes the techniques used for vascular occlusion, defines many of its indications and reviews some of the results and complications that have been reported with embolization procedures.     

Uterine artery embolization

The use of uterine artery embolization is a new approach in the treatment of uterine fibroids. Embolization is a technique in which blood vessels that supply nutrients and oxygen to fibroids are blocked. This blockage causes the fibroid muscle cells to degenerate and form scar tissue, thus shrinking the fibroid. Usually the fibroid no longer causes symptoms. This minimally invasive procedure involves an overnight hospital stay and results in a reduction of fibroid symptoms. Most women notice the greatest improvement in the first eight weeks. This procedure has been performed only since 1990 and, therefore, long-term results are unknown.     

Uterine fibroid embolization

Interventional radiologists have performed uterine artery embolization to treat women with emergency uterine bleeding since the 1970s. In this procedure, the physician guides a small angiographic catheter into the uterine arteries and injects a stream of tiny particles that decreases blood flow to the uterus. It is now considered a safe and highly effective nonsurgical treatment of women with symptomatic uterine fibroid tumors. Uterine fibroid embolization has several advantages over conventional hormonal suppression and surgical procedures, including avoidance of the side effects of drug therapy and the physical and psychologic trauma of surgery. In addition, after uterine fibroid embolization, patients can normally resume their usual activities several weeks earlier than they can after hysterectomy. Along with hysteroscopic resection, myolysis and laparoscopic myomectomy, uterine fibroid embolization widens treatment options for patients who desire to avoid hysterectomy.     

颈内动脉海绵窦瘘的经血管内栓塞治疗

目的:评价颈内动脉海绵窦瘘(CCF)经血管内栓塞治疗的方法及价值。材料和方法:分析14例经血管内介入治疗的颈内动脉海绵窦瘘病例,以带毛弹簧栓、可脱球囊或电解可脱弹簧栓(Guglielmi Detachable Coil,GDC)经动脉或静脉途径栓塞瘘口。6例采用带毛弹簧栓,共54个,其中1例同时经眼静脉穿刺逆行栓塞海绵窦。7例采用球囊栓塞,1例因为瘘口小无法放置弹簧栓和球囊而采用GDC栓塞。结果:本组中13例CCF瘘口完全堵塞,其中4例同时堵塞颈内动脉,患者症状消失。1例已有6年病史的CCF颈内动脉参与大脑供血无法栓塞,经栓塞与海绵窦相通的颈外动脉后,又经眼静脉栓塞海绵窦致瘘口明显缩小。结论:经动脉内以球囊、弹簧栓或GDC栓塞是治疗CCF的有效方法,其中以球囊栓塞操作安全简便为首选材料。引流静脉粗大者逆行栓塞可以起补充作用。     

Repeated systemic mercury embolization

Mercury embolization is an uncommon phenomenon that is easily diagnosed roentgenographically. We have reported a case of repeated self-administration of metallic mercury into the subcutaneous tissues. An intravenous component of the injection occurred, with systemic embolization to the lungs, CNS, pericardium, and diaphragm. These findings were demonstrated by plain films and CT, and were followed over a period of 15 months.     

Prostatic artery embolization: Progress and prospect

Prostate artery embolization is a well-known and promising treatment for benign prostatic hyperplasia, with the quantum leaps of research in medicine. We aim to provide an up-to-date review of the novel technique, including large retrospective studies and randomized control trials, ends with discussions of advantages and disadvantages of this minimally invasive technique.     

颅内微小动脉瘤血管内栓塞治疗

目的探讨颅内微小动脉瘤的介入处理原则。方法分析我院39例颅内微小动脉瘤患者的血管内栓塞结果。31例是出血的责任动脉瘤,8例为未破裂动脉瘤。其中颈内动脉2例,大脑中动脉M1段动脉瘤4例,大脑中动脉M1分叉处动脉瘤2例,前交通动脉16个,后交通动脉11个,大脑前动脉A1段动脉瘤3例,小脑后上动脉起始部动脉瘤1例。动脉瘤直径1.8～3.0mm,平均直径2.5mm,窄颈动脉瘤33个,宽颈6个。结果 39例患者中35例成功行血管内栓塞,2例单纯支架植入,2例未破裂动脉瘤未能栓塞。无死亡病例。结论颅内微小动脉瘤的介入栓塞较困难,应行个体化治疗。