肝癌患者经肝动脉栓塞术后低氧血症的原因分析

目的探讨肝癌患者经动脉化疗栓塞(TACE)术后低氧血症的相关因素.方法对肝癌患者58例(肝癌组)和因其他疾病行介入治疗的患者30例(非肝癌组)手术前、后血气变化进行检测,分别比较二者手术前后PO2的变化,以及二者之间手术前、后PO2变化,术后PO2下降与肝功能Child-Pugh分级、术中碘油用量、过敏体质的关系.结果肝癌组患者TACE术后PO2下降,与术前相比差异有显著性(P<0.001);非肝癌组介入手术前、后PO2变化差异无显著性(P>0.10);肝癌组较非肝癌组介入术后更易发生低氧血症(P<0.001);肝功能Child B级较A级更易发生低氧血症(P<0.001);碘油用量和低氧血症的发生呈正相关(P<0.05),与术后是否发生碘油肺栓塞有关,也与化疗药物引起的急性肺损伤有关.本组中未出现与过敏体质有关的低氧血症.结论肝癌行TACE术可引发低氧血症,低氧血症与肝功能Child分级相关.

Cause and management of hypoxemia after TACE

Objective To analyze the fac to rs involved in the hypoxemia after TACE for the hepatic carcinoma. Methods The patien ts were divided into two groups:hepatic carcinoma group (experiment group,n =58) and other disease group (control group,n=30). The blood gas results we re get before and after interventional procedure.The oxygen pressure,Child-pug h degree, amount of lipidol and allergic factors were analyzed. Results Oxygen pressure decreased significantly after TACE in experiment group(P<0.001). Oxygen pressure did not changed in control gr oup(P>1). Oxygen pressure decreased more considerably in experiment group than in control group(P<0.001).Hypoxemia was more seriously in Child B grad e than in Child A grade(P<0.001).A positive correlation were observed betwee n the amount of lipidol and the decrease of oxygen pressure(P<0.05).Pulmonary lipidol em boli sm might occur if the amount of lipidol was high enough. The pulmonary injury ca used by chemotherapeutant played a role in the hypoxemia.There was no relationsh ip betw een hypoxemia and allergy.Conclusion TACE for the hepatic carcinoma would result in hypoxemia.The hypoxemia was r elated to Child-Pugh degree.