急性下肢动脉闭塞的介入治疗

目的探讨血管腔内技术在急性下肢动脉闭塞治疗中的临床应用价值。方法总结25例急性下肢动脉闭塞介入治疗的经验。采用动脉内直接溶栓和经皮血管腔内成形术（动脉直径〉3mm）治疗下肢动脉闭塞。结果经术后3个月-8年临床观察急性单段动脉闭塞血管再通率为100％（14／14例），多段动脉闭塞血管再通率为54．5％（6／11例），血管总再通率为80％（20／25例）。结论血管腔内介入治疗技术是治疗急性下肢动脉闭塞的一种有效方法，值得临床推广应用。     

顺铂-碘化油混悬乳液经数字减影血管造影舌动脉栓塞化疗对晚期舌癌的临床病理分析

目的分析晚期舌癌术前栓塞化疗的临床疗效和病理变化。方法观察12例晚期舌癌患者术前接受选择性动脉内捅管化疗和动脉内栓塞化疗的结果。其中包括手术所见、组织病理学改变和临床疗效。结果12例舌癌的临床和组织病理学改变总有效率为83．33％。栓塞组1例（14．3％）完全缓解，6例（85．7％）部分缓解；未栓塞组3例（60．O％）部分缓解，2例（40．0％）无效，无恶化病例。组织病理变化为癌细胞萎缩、核同缩、胞浆凝同，血管内膜增厚，管腔狭窄。结论晚期舌癌术前行栓塞化疗，创伤轻微，疗效显著，可作为术前的一项常规治疗。     

介入治疗急性动脉闭塞20例的护理

目的：探讨介入治疗急性动脉闭塞的护理体会，以提高治疗的安全性。方法：采用血管腔内介入治疗、动脉溶栓、球囊扩张及支架置入术治疗急性外周动脉闭塞20例。术前心理护理及术前指导，术后注意观察患肢情况，加强术后护理。结果：溶栓治疗成功率61．6％，采用血管腔内成形治疗成功率80％，采用内支架置入术成功率100％。结论：术前、术后的全面观察和有效护理是患者治疗成功的保障。     

胃癌合并缺血性心脏病的手术治疗结果分析

目的：探讨胃癌合并缺血性心脏病的手术治疗方法和疗效。方法：对1988年1月-2006年12月住院治疗的39例患者的临床资料和治疗结果进行分析。结果：术前治疗3～7d,平均5．5d;住院19～26d,平均22d。无围手术期死亡病例。1,3,5年生存率为61．5％（24／39）,56．4％（22／39）,48．7％（19／39）。结论：复发和转移是主要死因。加强围手术期和后期治疗缺血性心脏病,可以提高胃癌患者的生存率。     

胃癌术前介入治疗的临床意义

目的：观察12例胃癌患者行术前介入治疗后的疗效结果.材料与方法：对12例进展期胃癌均行选择性胃动脉灌注化疗,详细记录了临床表现,影像诊断,手术所见,病理组织学和临床疗效.结果：组织学改变证实有效率为100%,其中中度有效率6例（50%）,轻度有效率6例（50%）,临床疗效表明缓解率为91%,完全缓解3例（85%）,部分缓解8例（66.6%）.均行Ⅱ期胃癌根治术.1年生存率100%,2年生存率11例（91.7%）,3年生存10例（83.3%）.结论：术前介入性动脉内灌注化疗是提高手术切除率及提高生存质量的有效方法。     

颅内深部小型动静脉畸形的血管内介入治疗

目的探讨颅内深部小型动静脉畸形血管内介入治疗的安全性及临床效果。方法回顾分析12例颅内深部小型动静脉畸形患者采用血管内介入治疗的临床资料,其中畸形位于基底节区6例,丘脑．基底节区4例,小脑上蚓部2例;采用Onyx或NBCA进行栓塞治疗。结果完全栓塞7例（58．3％）,次全栓塞3例（25％）,部分栓塞2例（16．7％）,残余畸形者行伽玛刀治疗,随访3个月至2年,平均12个月,无严重并发症及死亡病例。结论颅内深部小型动静脉畸形根据具体情况采用血管内介入栓塞,能收到满意的效果,但栓塞率和畸形血管构筑、供血动脉多少以及血管条件相关。     

三种微创治疗方法序贯联合治疗块状型肝细胞癌

【目的】探讨序贯联合肝动脉化疗栓塞（TACE）与经皮瘤内注药、射频消融（RFA）治疗块状型肝细胞癌（HCC）的临床疗效。【方法】对26例块状型HCC患者,共计39个瘤灶,先行TACE术,根据术后复查情况序贯联合TACE、经皮瘤内注药和RFA继续治疗。观察患者术前、术后6个月各相关指标的变化。【结果]26例患者,共行TACE术59人次,经皮穿刺瘤内注药术31人次,RFA术28人次。术后6个月甲胎蛋白（AFP）较术前明显下降（P〈O．01）。术后3个月、6个月的肿瘤体积分别较术前明显缩小（P〈0．01）。术后3个月肿瘤完全坏死率为89．7％。术前、术后3个月、6个月的肝、肾功能和血常规均在正常范围。1、2、3年患者生存率分别为76．92％、61．54％、34．62％。【结论】序贯联合TACE与经皮瘤内注药、RFA是一种对块状型HCC有效和可行的治疗方法。     

恶性梗阻性黄疸双介入治疗的临床应用

目的：总结双介入治疗恶性梗阻性黄疸的临床疗效。材料与方法：恶性梗阻性黄疸患者13例。年龄58～77岁，PTCD术后均留置内支架，后行TAIC治疗。比较手术前后血清胆红素变化情况及统计生存时间。结果：治疗后血清胆红素明吼下降，全部病例生存时问为6个月、12个月、18个月、24个月、36个月分别为84．6％（11／13）、61．54％（8／13）、46．15％（6／13）、30．77％（4／13）、15．38％（2／13）。结论：VFCD术后置入内支架结合TAIC治疗恶性梗阻性黄疸疗效好，确能提高患者生命质量，延长生存期。     

超选择性肝动脉栓塞治疗多囊肝的长期疗效观察

目的评价用超选择性肝动脉栓塞术（TAE）治疗多囊肝（PLD）的长期疗效和安全性。方法对23例有严重症状的PLD患者进行超选择性肝动脉栓塞术。患者女19例，男4例，年龄36．0～68．0岁，平均（49．3±3．4）岁。所有患者在TAE前后行上腹部CT平扫＋增强扫描：TAE后第3个月、第6个月及此后每间隔半年复查CT。结果23例患者共行27次介入治疗，手术技术成功率为100％，中位随访时间为19个月（3-58个月），2例无效，可供评价疗效者21例，有效率为91．2％。术前患者平均腹围为（105．7±8．1）cm，术后患者平均腹围为（95．2±6．7）cm，术前术后平均腹围具有统计学差异（P〈0．001）。平均腹围开始缩小时间（8．0±3．5）个月，症状改善时间（7．1±2．2）个月；栓塞后综合征多在栓塞术后7d内缓解，在术后第6天及长期复查肝功能均在正常水平。结论TAE治疗多囊肝，长期疗效可靠，安全性高，值得临床进一步推广应用。     

综合介入治疗伴肝功能失代偿肝癌临床分析

目的探讨伴失代偿性肝硬化肝癌综合介入治疗的临床价值。方法57例伴肝功能失代偿肝癌患者在内科治疗稳定后接受肝动脉节段性化学栓塞治疗（S-TACE），并在1～2周后序贯射频消融（RFA）或加无水乙醇局部注射（PEI）治疗。结果45例甲胎蛋白（AFP）升高患者于术后2～4周开始下降，32例（71．11％）逐渐达到正常；3个月后肿瘤缩小50％以上者为59．65％（34／57）；中位生存期13．7个月，6个月、12个月和24个月累计生存率分别为：75．44％（43／57）、40．35％（23／57）和19．30％（11／57）；变量Cox模型分析显示包括HBVDNA在内的14项因素与预后显著相关，多因素Cox模型分析显示靛氰绿15min排泄试验（ICGR15）、门静脉癌栓、治疗次数及AFP术前升高者介入后变化与预后显著相关。结论综合介入治疗是伴肝功能失代偿肝癌的有效治疗方法，对HBVDNA阳性患者应该考虑抗HBV治疗。     

原发性肝癌破裂出血的介入治疗

目的：分析原发性肝癌破裂出血经皮肝动脉介入栓塞治疗的效果。方法对32例原发性肝癌破裂出血,行碘油与明胶海绵联合弹簧钢圈、平阳霉素肝动脉栓塞治疗,分析其疗效。结果32例患者止血成功率为100%。术前平均动脉压（60.5±16.2）mmHg,术后平均动脉压（85.3±17.8）mmHg,术后血压明显升高,术后平均心率小于（115.5±22.8）次/分,术后1～6 h之后,无输血者的血红蛋白与入院时（68.1±11.5）g/L无明显下降。术后1、3、6、12、24和48个月生存率分别为96.9%（31例）、87.5%（28例）、62.5%（20例）、46.9%（15例）、34.4%（11例）及12.5%（4例）。结论经皮肝动脉栓塞术对治疗原发性肝癌破裂出血效果显著,不仅能达到立即止血目的,而且能治疗肿瘤,并为后继治疗创造条件。     

Transcatheter arterial embolization and chemoembolization induce the production of free radicals in the normal rat liver

Superselective transcatheter arterial embolization (TAE) of the left and median lobes of the normal rat liver was performed using gelatin sponge (1.5 mg/ml). Superselective transcatheter arterial chemoembolization (TAC) of the same lobes was done adding mitomycin (MMC) at a dose of 1.6 mg/ml to the embolic solution. In another group of rats MMC alone was injected intraarterially into those lobes. It was found that both embolic procedures and the arterial injection of MMC decrease the hepatic total glutathione content. Glutathione peroxidase activity and alpha-tocopherol content remained unchanged. Lipoperoxides were detected 3 and 6 h after TAC in chemoembolized and non-chemoembolized lobes. Similar findings in both injected and noninjected lobes were found after MMC injection. The TAE lobes only showed elevated lipoperoxide content 6 h after embolization, this parameter remained unchanged in the non-TAE lobes. These findings suggest that free radicals are formed after TAE, and that the addition of MMC to the embolic solution increases the oxidative attack and/or that the oxidative reactions after TAC are mainly mediated by lipid peroxidation due to the presence of MMC.     

急诊肝动脉栓塞治疗原发性肝癌自发性破裂出血

目的　评价肝动脉栓塞 (TAE)在原发性肝癌自发性破裂出血抢救治疗中的作用。方法　 35例原发性肝癌自发性破裂出血患者 ,根据不同的治疗方法分为 2组 :TAE组 2 3例和内科保守治疗组 1 2例。结果　TAE组 2 3例腹腔动脉造影 ,有 1 4例可见造影剂外渗 ,其余是肿瘤血供染色明显 ,止血有效率91 3% ,一年生存率为 4 7 8%。内科保守治疗组止血有效率 33 3% ,一年生存率为 0 ,两组差异有显著性(P <0 0 1 )。结论　TAE是原发性肝癌自发性破裂急诊止血的有效、安全措施。对可切除的肝癌患者 ,TAE后择期手术切除应作为首选的治疗方案     

经导管肝动脉化疗栓塞术围术期相关并发症的观察及护理

目的总结经导管肝动脉化疗栓塞术围术期相关并发症的观察及护理要点。方法回顾性分析本院2005年7月-2008年8月68例经导管肝动脉化疗栓塞术患者围术期相关并发症的发生情况,并总结护理经验。结果 68例患者围术期相关并发症情况:术中高血压19例,动脉栓塞1例;术后穿刺部位血肿1例,发热50例,恶心和呕吐8例,肝区疼痛42例,异位栓塞1例,消化道出血3例,骨髓抑制19例,肝功能损害37例,肾功能损害4例,经对症处理后,所有并发症均获得临床缓解。结论经导管肝动脉化疗栓塞术围术期易于出现并发症,护理人员应该了解并发症的发生原因及临床表现,并及时报告医生予以处理,其是保证手术取得成功的关键。     

双介入治疗复发性肝细胞癌

目的：为了评价复发性肝细胞癌的非手术治疗方法的疗效。方法：采用经皮肝动脉化疗栓塞（ＴＡＥ）结合Ｂ超引导下无水酒精注射（ＰＥＩ）双介入治疗５６例复发性肝细胞癌,并以同期ＴＡＥ治疗的４２昨发性肝癌及２８例手术再切除复发性肝癌为对照。结果：ＴＡＥ＋ＰＥＩ组的１,３,５年累计生存率分别为８９．０％,６６．５％和３３．８％,其中单个病灶者１．３,５年生存率为９１．３％,７９．６％和４６．９％。结论：ＴＡＥ＋     

Effects of superselective arterial embolization and chemoembolization on energy charge and total blood flow of the rat liver

The superselective transcatheter arterial embolization (TAE) and chemoembolization (TAC) of the periphery of the left and median lobes of the rat liver were performed using 1.5 mg of gelatin sponge dissolved in saline solution and mitomycin (MMC) at a dose of 1.6 mg/kg b.wt. The energy charge (EC) of the embolized and chemoembolized lobes decreased after the embolization but was restored 3 h later. The total hepatic blood flow (THBF) was reduced to about one half and required 1 week to be restored to the preembolization levels in both groups. Microscopic centrilobular necrosis and vacuolization were found. The addition of MMC did not produce marked untoward effects. Thus, the normal liver is able to restore its energy pool despite a reduction in the THBF after superselective arterial embolization, and this recovery is not altered even by the use of a high dose of MMC.     

Energy metabolism changes and oxidative attack after hepatic arterial embolization and chemoembolization in thioacetamide-induced cirrhotic livers

Hepatic energy metabolism and oxidative attack were studied after transcatheter arterial embolization (TAE) and chemoembolization (TAC) of the left and median lobes of the liver using thioacetamide (TAA)-induced cirrhotic rats. TAE was carried out using gelatin sponge (1.5 mg/cm3) dissolved in saline solution (SS). TAC was performed by adding mitomycin C (MMC) (1.6 mg/kg body weight) to the previous embolic solution. The energy charge (EC) of embolized lobes decreased from 0.86 to 0.78 and 0.74 1 h after TAE and TAC, respectively, but was restored 3 h later. Adenosine 5'-triphosphate (ATP) and total adenine nucleotide content (TAN) of embolized and non-embolized lobes was also temporarily decreased. Total hepatic blood flow (THBF) of embolized and chemoembolized lobes was reduced in almost 50%, and it took 1 week to become normalized. After TAC (3 and 6 h, respectively), total glutathione (TGSH) content was reduced from 7.02 mumol/g of liver to around 4.5 mumol/g, and malondialdehyde (MDA) content increased from 196.94 nmol/g of liver to values above 300 nmol/g. TAE in cirrhotic livers did not induce any changes in these parameters. In conclusion, after TAE and TAC the hepatic energy metabolism is temporarily altered by ischemia. TAC-induced oxidative attack, in addition to ischemia and MMC, could be one of the mechanisms explaining the effectiveness of this therapy.     

Energy metabolism changes and oxidative attack after hepatic arterial embolization and chemoembolization in thioacetamide-induced cirrhotic livers

Hepatic energy metabolism and oxidative attack were studied after transcatheter arterial embolization (TAE) and chemoembolization (TAC) of the left and median lobes of the liver using thioacetamide (TAA)-induced cirrhotic rats. TAE was carried out using gelatin sponge (1.5mg/cm³) dissolved in saline solution (SS). TAC was performed by adding mitomycin C (MMC) (1.6 mg/kg body weight) to the previous embolic solution. The energy charge (EC) of embolized lobes descreased from 0.86 to 0.78 and 0.74 1h after TAE and TAC, respectively, but was restored 3 h later. Adenosine 5′-triphosphate (ATP) and total adenine nucleotide content (TAN) of embolized and non-embolized lobes was also temporarily decreased. Total hepatic blood flow (THBF) of embolized and chemoembolized lobes was reduced in almost 50%, and it took 1 week to become normalized. After TAC (3 and 6h, respectively), total glutathione (TGSH) content was reduced from 7.02 μmol/g of liver to around 4.5 μmol/g, and malondialdehyde (MDA) content increased from 196.94 nmol/g of liver to values above 300 nmol/g. TAE in cirrhotic livers did not induce any changes in these parameters. In conclusion, after TAE and TAC the hepatic energy metabolism is temporarily altered by ischemia. TAC-induced oxidative attack, in addition to ischemia and MMC, could be one of the mechanisms explaining the effectiveness of this therapy.     

血清sICAM-1在肝细胞肝癌患者TAE术后的动态变化及其意义

目的:检测肝细胞肝癌(hepaticcellcarcinoma,HCC)患者经动脉导管栓塞术(transcatheterarterialembolization,TAE)后血清sICAM-1的动态变化,以了解其在判断HCC经TAE治疗后疗效及判断再次TAE指征方面的意义。方法:运用ELISA方法测定12例HCC患者第1次TAE前、术后3、10、30d以及第2次TAE术后血清sICAM-1的水平,并对比第1次术前和术后10d肿块大小与血清sICAM-1的关系。结果:TAE术前HCC患者血清sICAM-1水平(973.00±211.54)明显高于对照组(P<0.01)。TAE术后3d显著下降(611.67±145.02)(P<0.01),术后30d有所回升(811.13±133.18),但仍低于术前(P<0.05)。再次TAE后3d下降(568.43±106.28)(P<0.01)。第1次TAE术后10d肿块缩小程度跟相应的sICAM-1下降幅度成正比,线性回归分析r=0.88(P<0.05)。结论:血清sICAM-1对判断HCCTAE后再次TAE的指征及评价TAE效果方面有一定的价值。     

Safety and efficacy of transcatheter arterial embolization for management of refractory hematuria of prostatic origin

ObjectiveTo estimate the safety and efficacy of transcatheter arterial embolization (TAE) in the treatment of refractory hematuria of prostatic origin (RHPO).MethodsThis retrospective study included 23 patients who underwent TAE for RHPO between May 2013 and August 2021. Technical and clinical success rates were calculated, and arteriogram findings and complications were detected.ResultsEmbolization was performed 24 times in 23 patients. Technical success was achieved in 24/24 (100%) embolization procedures. Contrast agent extravasation was detected during 2 of the 24 angiographic procedures. Bilateral embolization was performed in 23 (95.8%) of the 24 procedures. The clinical success rate was 21/23 (91.3%), and hematuria stopped 1–4 days after TAE. No serious complications were observed.ConclusionTAE is a safe and effective minimally invasive technique for treating patients with RHPO.