髂内动脉输注和栓塞对盆腔肿瘤诊治的价值

目的:通过分析髂内动脉造影和栓塞治疗效果,结合CT、腔镜及术后病检结果,初步评估髂内动脉输注和栓塞治疗盆腔肿瘤的价值。方法:12例盆腔肿瘤患者,行双侧髂内动脉造影、输注后,作单侧或双侧供血血管的超选择插管栓塞,重点观察其血管造影表现和栓后临床症状的改善情况、CT扫描变化及术后病理检查结果,评估其疗效。结果:9例富血管肿瘤(6例膀胱癌、2例宫颈癌及1例子宫内膜癌)显示有典型的血管增多、增粗、不规则且有显著的肿瘤染色而得以诊断,而后行栓塞治疗,6例栓后手术病理发现瘤体不同程度的坏死,3例未行手术的患者,B超、CT发现瘤体明显缩小,血尿或阴道出血停止并维持达二月。3例少血管肿瘤(膀胱癌),没有明显的血供异常,仅行化疗并在1周内手术。结论:髂内动脉化疗输注和栓塞对盆腔肿瘤有较好的治疗价值。

Value of Internal Iliac Arterial Infusion and Embolization in the Management of Pelvic Tumors

Objective:To evaluate the efficacy and safety of selective arterial infusion and embolization of the internal iliac arteries in the management of pelvic tumors.Methods:12 consecutive patients with pelvic tumors were treated with selective arterial infusion and embolization of the internal iliac arteries after the bilateral internal iliac angiography.After the treatment,the angiographic manifestation,the improvement of clinic symptoms,CT findings and pathology were observed.Results:9 patients with hyper-vascular tumors (6 bladder cancers and 3 gynecologic tumors) were diagnosed and then treated with selective internal iliac arterial embolization.From all 9 patients,6 tumors were resected after embolization and tumor necrosis was observed.In other 3 patients,the tumors had decreased in size as followed by US/CT,and hemorrhage was stopped after embolization.The remaining 3 patients with hypovascular bladder cancers were treated by operation one week after the internal iliac arterial infusion.Conclusion:Selective internal iliac arterial infusion and embolization were safe and effective in treating pelvic tumors.