原发性肝癌肝外动脉供血及其临床治疗意义

目的:探讨原发性肝癌肝外动脉供血类型的分类、一般供血规律及其对临床治疗的意义。方法:回顾性分析185例原发性肝癌患者行经导管肝动脉化疗栓塞(TACE)术的DSA检查结果,对肝外动脉供血类型进行分类。结果:185例患者中存在215条肝外供血动脉,采用三分类法将其分为3类:1.变异肝动脉供血130条,占60.47%;2.肝动脉通畅肝外侧支供血35条,占16.28%;3.肝动脉闭塞或狭窄肝外侧支供血50条,占23.26%。其中后2类为非肝动脉供血。第1类以第1次TACE术时发现为主,第2类及第3类以第3次及以后TACE术时发现为主。非肝动脉供血与肝动脉通畅与否有关系。结论:原发性肝癌肝外动脉供血三分类法是一种较新的分类方法,具有简洁明晰的特点,对分析其类型与TACE术次数及肝动脉通畅与否的关系、指导肝癌的临床治疗具有重要作用。

Extrahepatic arterial blood supply of primary hepatic carcinoma and the clinical therapy

Objective:To discuss the classification, regularity of blood supply and the significance of clinical therapy of extrahepatic artery blood supply of primary hepatic carcinoma. Methods:The DSA results of 185 cases of primary hepatic carcinoma were checked by transcatheter arterial chemotherapy embolism (TACE) technique retrospectively, and the extrahepatic artery blood supply was classified into different types. Results:There were 215 extrahepatic arteries in 185 cases,and three types were included:1. The variant hepatic artery blood supply (130, 60.5%);2. Unobstructed extrahepatic blood supply of hepatic arteries (35,16.3%);3. Occlusive or narrow extrahepatic blood supply of hepatic arteries (50, 23.3%). The last two types are not the hepatic arteries. Conclusions: It was important to analyze the relation between times of TACE and unobstructed hepatic arteries, and it was valuable in the treatment of hepatic carcinoma.