肝血管瘤肝动脉栓塞的疗效评价(附26例报告)

目的 对经肝动脉途径介入栓塞肝血管瘤临床疗效进行评估。方法 26例肝血管瘤患者，男11例，女15例，年龄30-68岁，中位年龄44岁。肝左叶9例，右叶7例，两叶均有者10例；肝内单发病灶6例，多发者20例。有上腹隐痛、闷胀不适、贫血及腹部包块等症状者8例，无症状18例，均为查体时行B超探及。全部病例经B超、CT、核素扫描、肝动脉造影确诊。采用DSA设备，以Seldinger氏法经股动脉穿刺插管，行选择性肝动脉、肠系膜上动脉造影并栓塞。其中，9例行2次栓塞，17例为1次栓塞。栓塞材料采用超液态碘油 平阳霉紊 明胶海绵混合乳剂。结果 随访3个月～3年，8例有症状者均逐渐减轻、消失；CT复查示病灶内碘油沉积尚致密，范围不同程度缩小，部分显示钙化斑，16例缩小10％，6例缩小32．7％。结论 肝动脉栓塞治疗肝血管瘤临床疗效确切，患者痛苦小、微创伤、操作安全、简便、恢复快，可重复治疗；肝动脉造影对临床鉴别诊断、制订治疗方案及预后评价有不可替代的作用。

Evaluation of the therapeutic effect of liver artery embolism on liver angioma

Objective To evaulate the therapeutic effect of transcatheter liver artery embolism intervention on liver angioma. Methods There were 26 patients with liver angioma enrolled in this study,male 11 and female 15,aged from 30 to 68 years old (mean 44 years old).The angiomas in 9 patients were located in left liver lobule,7 in right lobule and 10 in both lobules- single angioma (n=6) and mutiple angioma(n=20).The syptoms in 8 patients were occult upper-abdomen pain,slightly swell,anaemia and abdomen mass,while in the other 18 patients were asymptomatic angioma found by ultrasonic examination. The angioma in all patients had been identified by ultrasonic-B,CT,nuclear scanning and liver artery angiography. The femoral artery puncture and catheter introduction with Seldinger's approach were applied,then selective liver and super-mesentery angiography and subsequently artery embolism with mixture of lipiodol+bleomycin+sponge(LBS) was performed.Twice embolisms in 9 patients and 1 times in 17 patients were completed. Results The symptoms disappeared or alleviated in 8 patients with symptomatic angioma after 3 months to 3 years in following-up,meanwhile the CT image showed still high but less acommulation of iodine in targets than prior to intervention and calcification in some patients were found .The size of angioma reduced about 10 % in 16 patients and 32.7 % in 6 patients. Conclusion The intervention of liver artery embolism has definite clinical effect on liver angioma,including the advantages of less suffering,small wound,safe and simple in performing- rapid recovery and can be operated repeatedly.Liver artery angiography plays an important role in differentiation,treatment planning and prognosis evaluation.