60℃碘油栓塞兔VX2肝癌

目的评价60℃碘油栓塞对兔VX2肝癌的抑瘤效果.方法将VX2瘤细胞接种于30只新西兰白兔肝左叶,建立兔肝癌模型,随机分3组,每组10只.经导管向肝动脉分别注入生理盐水、37℃碘油、60℃碘油,1周后观察各组肿瘤体积及血清AST水平,以及瘤兔的存活期.结果60℃碘油组生长率(0.92±0.21)与对照组(3.48±1.17)、37℃碘油组(1.29±0.26)相比有差异(P＜0.05).60℃碘油组存活期(41.0±3.0)与对照组(31.5±3.0)相比有差异(P＜0.05).60℃碘油组血清AST水平与37℃碘油组相比无差异(P＞0.05),与对照组相比有差异(P＜0.05).结论60℃碘油组可降低肿瘤生长率,延长存活期,肝功的损害是可逆的,且抑瘤效果更强.     

双介入疗法治疗晚期肺癌初步探讨

目的　探讨支气管动脉灌注化疗 (BAI)联合经皮肺穿碘油标记无水乙醇混悬液瘤内注射 (PAI)治疗晚期肺癌的临床价值。方法　对经细胞学证实的 13例肺癌及 5例肝癌双肺多发转移患者共 32只病灶 ,在电视或CT引导下施行了 5 2次BAI联合 78次PAI治疗 ,其中 1例治疗后行手术肿块切除 ,对其标本进行了病理组织学研究。结果　标本病理表现为肿瘤大面积坏死 ;治疗总有效率为 83.8% ;其 6、12、18个月生存率分别为 10 0 %、77.7%、6 1%。结论　BAI联合PAI这一双介入疗法既能治疗原发灶 ,又可控制转移灶 ,且对较大肺癌也取得了较好的疗效叠加作用 ,是一种较好的综合性治疗方案。     

Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: An autopsy case report

We report an extremely rare case of pulmonary lipiodol embolism with acute respiratory distress syndrome(ARDS) after transcatheter arterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). A 77-yearold man who was diagnosed with a huge HCC wasadmitted for TACE. Immediately after the procedure, this patient experienced severe dyspnea. We suspected that his symptoms were associated with a pulmonary lipiodol embolism after TACE, and we began intensive treatment. However, his condition did not improve, and he died on the following day. A subsequent autopsy revealed that the cause of death was ARDS due to pulmonary lipiodol embolism. No cases have been previously reported for which an autopsy was performed to explain the most probable mechanism of pulmonary lipiodol embolism; thus, ours is the first report for such a rare case.     

131I lipiodol therapy for unresectable hepatocellular carcinoma

Background : More than 80% of hepatocellular carcinoma tumours (HCC) are unresectable at presentation because of the multicentric nature of the disease or the severity of liver disease. Arterially administered lipiodol is preferentially retained by HCC and has been used as a vehicle for delivery of therapeutic agents to the tumour. The aim of this phase I study is to present the experience with ¹³¹I‐labelled lipiodol in the treatment of unresectable HCC. Methods : ¹³¹Iodine lipiodol treatment was administered to 12 patients with unresectable HCC between 1994 and 1999. The outcome of treatment in these patients was evaluated for survival, clinical tolerance, liver function tests, α‐fetoprotein (AFP) levels and changes in tumour size on computed tomography (CT) scans. Results : Ten of the 12 patients received more than one ¹³¹I treatment. Five patients had treatment for post‐resection recurrence. Serum AFP levels dropped initially in five of the seven patients with elevated values. Tumour size, evaluated by CT scans at 3 months, decreased in six patients and remained stable in the rest, except one patient in whom both the AFP level and tumour size had increased. Using life table analysis, the 50% survival was 19 months. Conclusions : Intra‐arterial ¹³¹I treatment was very well tolerated. A reduction in AFP levels and tumour size occurred in half of the patients and resulted in a 50% probability of survival of 19 months. Further examination of the value of this treatment in phase II and III studies is required.     

A kit formulation for the labelling of lipiodol with generator‐produced 188Re

A lyophilised kit formulation for the efficient labelling of lipiodol with generator‐produced ¹⁸⁸Re is described. This method involves the reaction of [¹⁸⁸Re^VIIO₄]^? (37–370 MBq) with SnCl₂ as a reducing agent, potassium oxalate as a reduction promoter, ascorbic acid as antioxidant and sodium gluconate as a weak chelate. The intermediate compound Na[¹⁸⁸Re^VO(gluc)₂] reacts with the sodium salt of a dithiobenzoate ligand to give the neutral complex [¹⁸⁸Re^III(PhCS₃)₂(PhCS₂)]. This complex is then quantitatively extracted with lipiodol to afford a stable solution. Radiochemical purity (RCP) was greater than 90% and the yield of extraction was about 88%. The role of the different kit components has been studied in detail to find the most efficient formulation (amount of reducing agent, antioxidant). The use of 0.8 mg of stannous chloride, with 40 mg of potassium oxalate and 30 mg of ascorbic acid, was found necessary. The stability of the ¹⁸⁸Re‐radiolabelled lipiodol has been investigated, in the presence of plasma. The radiolabelled lipiodol (¹⁸⁸Re‐SSS lipiodol) is stable at least 48 h (RCP=91.0±4.0%). Copyright © 2004 John Wiley & Sons, Ltd.     

平阳霉素和碘化油乳剂供血动脉栓塞治疗肝巨大海绵状血管瘤疗效评价

目的 评价平阳霉素和碘化油乳剂供血动脉栓塞治疗肝海绵状血管瘤的疗效.方法 21例肝海绵状血管瘤患者,男7例,女14例,瘤体直径6～20.8cm.将导管超选择插入肝海绵状血管瘤供血动脉,注射平阳霉素和碘化油乳剂进行栓塞治疗,巨大肿瘤用明胶海绵条配合阻断供血动脉主干血流.根据肿瘤大小分别进行1～3次栓塞,术后3～6个月后复查.结果 21例患者供血动脉栓塞均获得成功,达到血窦内碘化油聚集和瘤体血供截流的栓塞效果;术后无严重并发症及肝功能损害,临床症状得到缓解,瘤体病灶内瘤状血管消失,随时间延长,瘤体逐渐缩小.结论 平阳霉素和碘化油乳剂供血动脉栓塞应成为治疗巨大肝海绵状血管瘤首选的治疗方案.     

平阳霉素超液化碘油及明胶海绵治疗肝血管瘤的疗效分析

目的评价平阳霉素超液化碘油及明胶海绵栓塞肝海绵状血管瘤的临床疗效。方法对18例肝海绵状血管瘤患者采用Seldinger技术股动脉插管，将导管超选择至肿瘤供血动脉，缓慢注入利多卡因5～10mL及平阳霉素超液化碘油10～15mL，以及适量明胶海绵颗粒。术后3～15个月B超、CT随访观察肿瘤栓塞前后直径大小变化、11名床症状缓解及并发症情况。结果18例肝海绵状血管瘤均见平阳霉素超液化碘油完全充填。病灶完全消失5例，缩小50％以上10例，缩小50％以下3例。临床症状明显好转，无明显并发症。结论平阳霉素超液化碘油及明胶海绵治疗肝海绵状血管瘤疗效良好，微创、安全、并发症少。     

透视下经皮注射博莱霉素碘油乳剂治疗眶内静脉畸形患者的护理

总结了眶内静脉畸形患者在透视下经皮穿刺局部注射博莱霉素碘油乳剂的护理经验。患者术前多存在自卑心理,予加强心理疏导。完善术前检查及准备,尤其是影像学检查。患者术后局部肿胀明显,术后协助取高枕位,以利头部静脉回流;做好患者术后局部胀痛及患侧头痛的护理;患者术后眼球突出明显,眼睑闭合不全,存在发生暴露性角膜炎和角膜溃疡的危险,指导患者外出时戴上深色眼镜或加盖眼罩保护,加强角膜保护,鼓励患者多食含丰富维生素A的食物加强角膜上皮营养,眼部水肿较重者,予50%硫酸镁湿敷,必要时予地塞米松静脉滴注。结果 所有患者未发现眼眶内出血、皮肤坏死、异位栓塞和暴露性角膜炎等并发症。     

Lipiodol fertility enhancement: two-year follow-up of a randomized trial suggests a transient benefit in endometriosis, but a sustained benefit in unexplained infertility

BACKGROUND: A New Zealand randomized trial has shown that lipiodol treatment enhances fertility with high short-term effectiveness for women with endometriosis. METHODS: An open randomized trial in a single-centre secondary- and tertiary-level infertility service assessing lipiodol flushing versus no intervention. A total of 158 women with unexplained infertility (62 women with mild endometriosis and 96 women with pure unexplained infertility) were evaluated at 24 months after trial entry. The main outcome measure was clinical pregnancy, assessed using a Cox proportional hazards regression model. RESULTS: There was a significant benefit in overall pregnancy rate following lipiodol [hazard ratio 2.0, 95% confidence interval (CI) 1.3-3.2]. Among women with endometriosis, the benefit in pregnancy rate seen in the first 6 months following lipiodol (hazard ratio 5.4, 95% CI 2.1-14.2) was not present at 6-24 months (hazard ratio 0.6, 95% CI 0.2-2.1). There was a more consistent effect of lipiodol on fertility throughout the 24-month follow-up among women with unexplained infertility (hazard ratio 2.0, 95% CI 1.1-3.5). CONCLUSIONS: Lipiodol flushing is effective at enhancing fertility not only for women with endometriosis, but also for those with pure unexplained infertility.     

子宫输卵管碘水造影与选择性输卵管碘水造影再通术180例X线影像及临床分析

目的探讨女性不孕症患者行子宫输卵管碘水造影与选择性输卵管碘水造影再通术后的影像征象及临床应用。方法对180例不孕患者,做完子宫输卵管碘水造影(对比剂为76%复方泛影葡胺注射液),再行选择性输卵管碘水造影。比较输卵管通畅程度诊断的一致性。结果180例中126例子宫输卵管碘水造影和选择性输卵管碘水造影对输卵管通畅程度的诊断一致,54例不完全一致。结论正确分析女性不孕症患者子宫输卵管碘水造影影像平片,子宫输卵管碘水造影能清楚地显示宫颈、宫腔、宫角及输卵管通畅情况,而选择性输卵管碘水造影再通术对输卵管通畅情况显示得更准确,并有一定的治疗作用,两者互相补充,有助于对此病制订合理的治疗方案。