超选择性肝动脉栓塞治疗多囊肝的长期疗效观察

目的评价用超选择性肝动脉栓塞术（TAE）治疗多囊肝（PLD）的长期疗效和安全性。方法对23例有严重症状的PLD患者进行超选择性肝动脉栓塞术。患者女19例，男4例，年龄36．0～68．0岁，平均（49．3±3．4）岁。所有患者在TAE前后行上腹部CT平扫＋增强扫描：TAE后第3个月、第6个月及此后每间隔半年复查CT。结果23例患者共行27次介入治疗，手术技术成功率为100％，中位随访时间为19个月（3-58个月），2例无效，可供评价疗效者21例，有效率为91．2％。术前患者平均腹围为（105．7±8．1）cm，术后患者平均腹围为（95．2±6．7）cm，术前术后平均腹围具有统计学差异（P〈0．001）。平均腹围开始缩小时间（8．0±3．5）个月，症状改善时间（7．1±2．2）个月；栓塞后综合征多在栓塞术后7d内缓解，在术后第6天及长期复查肝功能均在正常水平。结论TAE治疗多囊肝，长期疗效可靠，安全性高，值得临床进一步推广应用。

The safety and long-term efficiency of transcatheter super-selective hepatic arterial embolization for treatment with polycystic liver disease

Objective To evaluate the safety and long-term efficacy of transcatheter super-selective hepatic arterial embolization （TAE） for patients with polycystic liver disease （PLD）. Methods A total of 23 patients with symptomatic PLD were enrolled. The patients consisted of nineteen women and four men aged 36.0-68.0 years, mean age （49.3 ± 3.4）years]. All patients underwent contrast enhanced computed tomography （CT） scan of the liver before TAE and at every 3 months for the first half year after TAE, and at 6-monthly intervals thereafter. Results Follow-up was performed at a median of 19 months （range 3-58 months）. 23 cases were treated by intervention 27 times, All procedures were successful without serious complications. TAE failed to benefit in 2 patients, but there were no complaints of worsening of the symptoms, available for 21 patients evaluable for efficacy, effective rate of 91.2%. The average preoperative abdominal circumference was （ 105.7± 8.1 ） cm, the average postoperative abdominal circumference was （95.2±6.7） era. After treatment average abdominal circumference reduction 10.1 cm （3.0-21.0 cm）, statistically significant （P〈0.001）. After treatment average abdominal circumference began to reduce time（7.0± 3.5）mon], symptoms improved time （9.1 ±4.2）mon]. Embolizafion syndrome returned to the normal range wilhin 1-7 day in all patients. Conclusion Transcatheter super-selective hepatic arterial embolization for patients with polycystic liver disease is a safe and long-term effective treatment for PLD patients, worthy of further clinical expand the application.