原发性肝癌合并动静脉瘘的介入治疗(附34例报告)

目的：探讨超选择性明胶海绵瘘口栓塞术对原发性肝癌所致动静脉瘘的治疗方法及疗效。方法：本组对34例经DSA检查确诊为原发性肝癌合并动-静脉瘘（AVS）行超选择性瘘口栓塞，根据瘘口闭塞及肿瘤染色情况确定是否行肿瘤碘化油栓塞治疗。闭塞瘘口材料主要为明胶海绵辅以弹簧圈。结果：34例中33例一次性瘘口闭塞成功，其中28例成功地行肿瘤栓塞治疗，1例因瘘口闭塞早期即发生肺栓塞症状，1月后行弹簧圈瘘口闭塞成功。结论：超选择性明胶海绵瘘口栓塞术对原发性肝癌所致的动静脉瘘的治疗是一种安全、有效、并发症少的治疗方法，能为肿瘤碘化油栓塞提供良好治疗环境。

Interventional therapy of primary liver cancer complicated by arterial-portal venous shunts (Report of 34 cases)

Objective:To find out the therapeutic method of superselective embolization with gelfoam at the shunt of arterial-portal venous shunts resulted from primary liver cancer and their effect.Methods:34 cases who were surely diagnosed as primary liver cancer conplicated by arterial-portal venous shunts(AVS)through the examination of DSA(digital subtraction angiography) were generally performed on superselective embolization with gelfoam and coil at the shunt,if unsuccessfully with gelfoam and then were carried out on interventional therapy of embolization with lipoidol at the tumor according to the condition of embolism at the shunt and blood vessel of the tumor.Results:33 cases were successfully performed on embolization,and 28 of the 33 cases were successfully carried out on therapeutic embolization at the tumor.But one case was successfully performed on embolization with coil one month later because the symptom of lung embolism had appeared soon after embolization with gelfoam at the same place.Conclusion:Superselective embolization with gelfoam at the shunt is safe, effective and full of little complications to the therapy of arterial-portal venous shunts resulted from primary liver cancer, and it can afford good therapeutic circumstances for embolization with lipoidol at the tumor.