海藻酸钠微球联合碘化油平阳霉素乳剂在肝海绵状血管瘤栓塞术中的临床应用

目的进一步减轻肝海绵状血管瘤（cavernous hemangioma of liver,CHL）血管介入栓塞治疗的不良反应,寻找效果更好的栓塞剂。方法将60例CHL患者随机平均分为3组,每组20例。（1）SAM＋PLE组：海藻酸钠微球（sodium alginate microsphere,SAM）＋碘化油平阳霉素乳剂（pingyangmycin lipiodol emulsion,PLE）;（2）PLE组;（3）SAM组。分别行血管栓塞术,术后常规对症处理,包括止痛、保肝治疗、抗炎处理。分别对3组患者术前、术后7d肝功能,术中术后不适反应,术后3个月CT复查肿瘤的改变情况以及术后3个月临床症状缓情况进行比较。结果3组栓塞剂对肝功能的影响以PLE组最大;在术中、术后出现不适反应以SAM组最多;3组栓塞剂对于CHL治疗疗效无明显差异。结论SAM＋PLE乳剂为安全有效的栓塞剂,使用方便,对肝功能影响少,术中术后反应轻,建议在肝海绵状血管瘤的栓塞中推广使用。

Sodium alginate microsphere combined with pingyangmycin lipiodol emulsion for clinical treatment of cavernous hemangioma of the liver

Objective To further reduce the adverse reactions of vascular embolization therapy for cavernous hemangioma of the liver（CHL）in order to find better embolizing agents.Methods Sixty CHL patients were randomly and evenly divided into three groups：embolization therapy with sodium alginate microsphere（SAM）＋pingyangmycin lipiodol emulsion（PLE）（group SAM＋PLE）,PLE（group PLE）and SAM（group SAM）.The routine postoperative symptomatic treatments were conducted,including odynolysis,liver-protection and anti-inflammatory therapy.The liver function and the intraoperative or postoperative discomfort symptoms before and 7 days after operation,and the changes in tumors were examined with CT scan.Clinical symptoms 3 months after operation were respectively compared.Results The greatest impact on liver function was seen in group PLE among the three groups.The maximum intraoperative or postoperative discomfort symptoms were seen in group SAM,but the therapeutic effectiveness of the three groups had no significant difference.Conclusion SAM＋PLE is a safe and effective embolizing agent,being user-friendly,minor in the effect on liver function and light in the intraoperative and postoperative reaction.It is recommended that SAM＋PLE be widely used for cavernous hemangioma of the liver.