肝脏海绵状血管瘤平阳霉素乳剂栓塞治疗的疗效观察

目的 评价平阳霉素和超液化碘油乳剂栓塞治疗肝脏海绵状血管瘤的临床疗效。方法 对12例患者采用seldinger技术经股动脉置管，超选择至肿瘤供血动脉，先缓慢注入2％利多卡因5-10ml，再用平阳霉素一超液化碘化油乳剂5—30ml进行栓塞，病变大于10cm且有多支血管供血者，或多叶分布的可分次给予介入治疗。注意临床症状缓解情况及并发症。术后2—48个月复查CT或超声随访，观察肿瘤直径、形态变化、瘤中碘化油的分布等。结果12例肝海绵状血管瘤均见平阳霉素-超液化碘油乳剂的完全性或部分性填充。病灶完全消失5例，缩小50％以上7例。临床症状好转率达92％。1例并发胆囊炎，8例术后肝功能异常，经1—2周保肝治疗后恢复正常。结论 平阳霉素一超液化碘油乳剂动脉栓塞肝脏海绵状血管瘤疗效较好、微创、安全、副作用少，可作为首选治疗方法。

The therapeutic effect of pingyangmycin lipiodol of ultra fluid emulsion embolization for hecpatic cavernous hemangioma

Objective To study the effect of embolization with pingyangmylin-lipiodol of ultra fluid emulsion(PLE) in treatment of cavernous hemangioma of liver(CHL).Methods 12 cases were treatment with pingyangmylin-lipiodol of ultra fluid emulsion by transcatheter arterial embolization with seldinger technique.The catheter was super-selectively sent into the supplying artery of tumof.5-10ml lidocaine and 5-30ml of PLE wrer slowly injection.The embolization was conducter in several times with patients with size of tumor larger than 10cm or tumor with multiple suppling arteries and tumor located more than one area.During 2-48 months follow-up after the operation.The change of the tumor diameter before and after the embolizations were compared by using CT and ultrasound.The clinical symptoms and the complications were also observed.Results The CHL of all the 12 cases were filled up by PLE.The foci were completely vanished in 5 cases reduced by over 50% in 7 cases resectively.The improving rate of the clinical symptoms reached 92%.one cases complicated with cholecystitis,eight cases complicated with abnormal function in liver and recovered after treatment.Conclusion The PLE embolization in treatment with hepatic cavernous hemangioma proved to be reliable safe.Minimally invasive and little side effect.This therapy can be the first method to choice in treatment with CHL.