经导管动脉化疗栓塞术治疗椎体转移瘤疼痛

目的探讨TACE在治疗椎体转移瘤疼痛中的价值。方法应用介入微创技术对8例椎体转移瘤引起剧烈疼痛患者经腰动脉、肋间动脉等肿瘤供养血管插管行TACE治疗。随访术后病情变化及疼痛缓解情况。结果治疗后肿瘤生长得以抑制,疼痛症状明显缓解或减轻。应用视觉模拟评分及止痛药用量同时评估,疼痛缓解有效率分别达87.50%（7/8）和75.00%（6/8）。结论腰动脉和肋间动脉等供血血管TACE能有效缓解椎体转移瘤引起的剧烈疼痛,控制肿瘤发展,可作为一种姑息治疗椎体转移瘤的方法。     

骨肿瘤动脉栓塞后组织学初步观察

作者对２６例巨大骨肿瘤行肿瘤供血动脉栓塞前活检和栓塞后不同部位切取的标本作了病理形态学对比研究观察。结果表明：（１）明胶海绵能栓塞骨肿瘤的供血动脉，起到减少术中肿瘤出血作用。（２）栓塞是肿瘤组织细胞退变、坏死的重要原因，起到阻止肿瘤生长，缩小肿瘤体积，有利于手术治疗和起到对某些骨肿瘤的终极治疗及姑息性治疗作用。（３）栓塞对肿瘤周围软组织、骨组织影响小，但仍应注意栓塞范围，避免重要组织的误栓。     

经导管髂内动脉栓塞在骨盆切除术中的意义

目的：研究和评估经导管髂内动脉栓塞后手术治疗骨盆肿瘤的价值和方法。方法：对30例骨盆肿瘤病人进行双侧髂内动脉栓塞,栓塞后1周内行手术治疗。结果：30例肿瘤均获彻底切除,术中出血大在和,平均出血为2200ml,平均随访28月,未见肿瘤局部复发。结论：术前经DSA栓塞双侧髂内动脉,可有效减少术中出血,利于种瘤切除,是骨盆肿瘤切除的十分有效的辅助治疗方法。     

选择性动脉栓塞在骨肿瘤治疗中的应用

选择性动脉栓塞在骨肿瘤治疗中的应用章祖成王继芳许多骨肿瘤，特别是位于脊柱、骨盆部位的骨肿瘤，由于受侵器官本身及周围组织器官解剖结构复杂、位置深在、肿瘤体积较大、术中出血多，因而治疗十分困难。近２０年来经皮选择性动脉栓塞（ｓｅｌｅｃｔｉｖｅａｒｔｅｒｉ...     

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。     

经导管前列腺动脉栓塞治疗前列腺增生疗效观察

目的评价对不耐受或不欲接受外科手术且药物治疗效果差的前列腺增生患者行经导管前列腺动脉栓塞(PAE)的安全性及有效性。方法对15例经药物治疗无效且伴有中重度下尿路梗阻(LUTS)症状的前列腺增生患者行PAE治疗。观察术后并发症情况,并分别于术后1、3、6、12个月复查国际前列腺症状评分(IPSS)及生活质量(Qol)评分,比较术前与术后不同时间患者IPSS、Qol评分的统计学差异。结果 15例PAE术后均未出现严重并发症,仅有轻度下腹部疼痛或尿道烧灼感(3/15,20.00%)、穿刺处淤斑(1/15,6.67%)及不同程度发热(4/15,26.67%)。患者术前及术后不同时间IPSS、Qol评分差异均有统计学意义(F=8.90、15.97,P均0.01);术后1、3、6、12个月患者IPSS、Qol评分均较术前明显减低(P均0.01)。结论对于不耐受或不欲接受外科手术且药物治疗效果差的前列腺增生患者,PAE治疗安全、有效。     

经导管动脉栓塞治疗肺隔离症1例

患者男,34岁,主因“间断性左胸痛4年、咯血20天”入院。查体及实验室检查无阳性发现。胸部CT：左下肺胸主动脉旁见索条状、不规则形高密度影,与胸主动脉相连,增强扫描强化程度与主动脉相同。入院诊断：左下肺隔离症。     

经导管动脉栓塞术治疗动脉性上消化道出血

目的评价经导管动脉栓塞术治疗动脉性上消化道出血的临床疗效。方法回顾性分析58例上消化道出血患者的临床资料。对58例动脉性上消化道出血患者行动脉造影,发现出血征象时超选择插管造影,并根据不同出血原因和出血部位采用不同栓塞材料进行栓塞。随访1~3个月,并观察疗效。结果 58例患者中,50例动脉造影表现为对比剂外溢、假性动脉瘤、血管畸形等,栓塞治疗止血有效率为94.00%（47/50）,栓塞后再出血率为4.26%（2/47）,未见严重并发症。结论经导管动脉栓塞术治疗动脉性上消化道出血安全、有效,具有较高临床应用价值。     

经导管选择性动脉栓塞治疗创伤性假性动脉瘤

目的探讨经导管选择性动脉栓塞治疗损伤性假性动脉瘤的疗效。方法 16例损伤性出血患者,其中肾脏出血5例,肝脏出血3例,剖宫产后出血4例,切口妊娠流产1例,宫颈癌放疗后出血1例,骨外伤术后出血2例。采用经股动脉穿刺选择性插管进行靶动脉造影及栓塞治疗。采用明胶海绵和（或）弹簧钢圈栓塞瘤腔及供血动脉。结果全部患者动脉造影均见假性动脉瘤,其中2例伴有动静脉瘘。栓塞成功率100%,栓塞后即刻造影示假性动脉瘤消失,止血成功率93.75%。术后均未发生严重并发症,随防6个月均无复发。结论经导管选择性动脉栓塞治疗损伤性假性动脉瘤性出血安全有效、创伤小、并发症少,是可靠的治疗方法 。     

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。     

选择性出血动脉栓塞在外伤性脾脏破裂出血处理中的应用

目的探讨选择性出血动脉栓塞在处理外伤性脾脏破裂出血中的效果。方法采用Seldinger技术穿刺右侧股动脉,把导管放至脾动脉后造影,显示脾脏出血部位,然后把微导管放至出血（叶、段）血管,注入PVA、明胶海绵颗粒等栓塞剂进行止血。结果44例脾动脉造影显示脾外伤（夏氏分级）Ⅱ级23例,Ⅲ级19例,Ⅳ级2例。44例均顺利完成选择性出血血管栓塞,其中脾叶动脉血管栓塞13例,脾段动脉血管栓塞31例;1次栓塞成功35例,再次栓塞成功9例。无继发出血及开腹手术病例,无死亡病例。术后1周血红蛋白、红细胞压积恢复正常。44例随访0.5～1年,无再出血、严重感染及其他并发症发生。结论选择性脾动脉出血血管栓塞是治疗外伤性脾破裂出血的一种有效、简便、微创的方法。     

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.     

肋间动脉栓塞治疗咯血的临床价值

目的探讨肋间动脉栓塞在经导管栓塞治疗咯血中的临床价值。方法2000年4月～2005年6月，采用经导管明胶海绵栓塞治疗91例咯血。术后密切观察并发症的发生，复发病例明确咯血的复发原因后再次手术。结果91例经111次手术，行支气管动脉联合肋间动脉栓塞74例，单独肋间动脉栓塞17例。即刻止血率98．9％（90／91）。随访8～14个月，复发率15．4％（14／91）。无严重并发症发生。结论在有效避免严重并发症发生的前提下，支气管动脉栓塞同时联合栓塞肋间动脉，能提高疗效，降低复发率。     

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.     

外固定骨延长术在下肢骨肿瘤外科治疗中的应用

目的 探讨下肢骨肿瘤保肢手术的新方法以提高患者的生活质量。方法 （１）８例患者中，４例高分化骨肉瘤，手术前后给均予正规化疗；２例骨巨细胞瘤和２例骨母细胞瘤未化疗。（２）所有病例均按Ｅｎｎｅｋｉｎｇ诊断分级标准分级。首先完整切除肿瘤，然后同期应用半环式外固定架在骨缺损处行加压融合，在胫骨的干骺端截骨处行骨闸缓慢牵伸延长术，重建下肢功能。结果 行正规化疗的４例高分化骨肉瘤患者术后存活２９￣４８个月，保     

肾恶性肿瘤动脉栓塞术

目的 减少肾恶性肿瘤术中出血，提高切除率及对晚期患者的姑息治疗疗效。方法 １９８１年２月￣１９９６年１０月，对５０例肾恶性肿瘤进行了肾动脉栓塞治疗。本组肿瘤〉７ｃｍ者占９６％，用明胶海绵，钢丝圈及抗癌药施行整体式栓塞。结果 栓后行根治术者４６例，平均出血２５４ｍｌ，提高切除率１０％。一多有程度不同的疼痛，发热。手术切除间隔期４８小时以内者占８２％。本组无合并症及死亡。结论 肾动脉栓塞术是有效而安全     

Transcatheter Embolization of Internal Pudendal Artery Pseudoaneurysm Following Traumatic Urethral Catheterization

Urethral catheterization is a routine procedure. We report an unusual complication due to a traumatic urethral catheterization. The resulting pseudoaneurysm of the bulbar artery required selective embolization of the internal pudendal artery.