肾动脉灌注化疗与多重栓塞治疗肾癌的临床应用 (附31例报告)

目的探讨肾动脉灌注化疗联合多重栓塞技术应用于肾癌临床治疗的价值。方法对31例经临床诊断和/或病理证实的肾癌患者施行选择性肾动脉插管灌注化疗与多重栓塞,化疗药物以吡柔吡星（THP）、丝裂霉素（MMC）、顺铂（DDP）三联使用,以碘化油、明胶海绵及弹簧栓为栓塞材料进行多重栓塞,观察手术所见和介入栓塞后临床效果。结果所有病例的肿瘤供血动脉及瘤内血管均栓塞成功。术中见栓塞后靶区大部分肾脏和肿瘤组织坏死,肾周组织水肿,与周围组织分界清楚,容易剥离,术中出血减少,术野清晰。姑息性治疗患者腰痛、血尿等症状明显缓解。结论肾癌手术前实施选择性肾动脉插管化疗联合多重栓塞有助于降低手术风险和肿瘤的完整切除,减少因手术挤压经静脉路回流造成的远处转移;对未能接受手术治疗的患者也不失为一种有效的姑息性治疗方法。

Clinical application of renal artery infusion chemotherapy and multiple embolotherapy on renal carcinoma: Report of 31 cases

Objective To discuss the value of clinical treatment for renal carcinoma by renal artery infusion chemotherapy plus multiple embolization technology.Methods Thirty-one patients with renal carcinoma(by clinical diagnosis and/or pathologically confirmed)were choosen,renal artery infusion chemotherapy and multiple embolotherapy(chemotherapy drags include THP,MMC and DDP,embolic material include iodized oil,gelatin sponge and spring shuan)were selectively given to them,then the surgical findings and clinical results after embolization were observed.Results In all cases,the blood vessels within the tumor and tumor-feeding artery embolization were successful,most kidney and tumor necrosis.Perirenal tissue edema after embolization,with clear boundaries around the surrounding tissue and easy decoherence,less bleeding,clear field.Patients with palliative treatment felt that symptoms such as low back pain,hematuria eased significantly.Conclusion Give selectively renal artery infusion chemotherapy and multiple embolotherapy before kidney operation help to reduce the risk of operation,cut the tumor completely and reduce the distant metastasis caused by squeezing through venous return.It is also an effective palliative treatment for patients who are unable to receive surgical treatment.