摘要
目的探讨肝动脉化疗栓塞术中胆囊动脉及胆囊显影与术后胆囊炎的关系。方法回顾性分析183例肝肿瘤患者接受肝动脉化疗栓塞术动脉造影时出现胆囊动脉和(或)胆囊显影的临床资料,对出现术后胆囊炎的48例所采用的治疗方式、次数与发生胆囊炎的关系进行相关性分析。结果48例患者(肝癌42例,肝血管瘤6例)TACE后并发胆囊炎(26.2%),42例并发胆囊炎的肝癌患者化疗方案为:FUDR(或5-FU)+HCPT+BLM11例,FUDR(或5-FU)+HCPT+DDP(或CP)9例,FUDR+HCPT+BLM+DDP(或CP)6例,FUDR+HCPT+EPI7例,FUDR+MMC+CP4例,含草酸铂(L-OHP)方案5例(其中2例发生2次以上胆囊炎)。6例并发胆囊炎的血管瘤患者治疗方案均为BLM粉8～24mg溶于超液化碘油5～10ml内栓塞。结论肝TACE时胆囊动脉及胆囊显影者术后发生胆囊炎的概率增高,化疗、栓塞方案(栓塞剂)含DDP、BLM及L-OHP粉剂的发生率更高,越过胆囊动脉后进行化疗栓塞可降低其发生。
Objective To investigate the relationship between post-TACE cholecystitis and cystic artery together with cholocystic opacification on hepatic arteriography during TACE. Methods The clinical data of 183 patients with liver tumors received trans-arterial chemoembolization （TACE）were retrospectively studied including opacification of the cystic arteries and/or cholesystic staining on hepatic arteriography in all these patients. The relationship between post-TACE cholecystitis and the treatment protocol in 48 cases was analyzed. Results 48 （HCC 42, hemangioma 6）among the 183 patients developed post-TACE cholecystitis （26.2%）. Chemotherapeutic protocols applied for the 42 cases with hepatic cancer were： FUDR/5-FU ＋ HCPT ＋ BLM 11 cases, FUDR/5-FU ＋ HCPT ＋ DDP/CP 9 eases, FUDR ＋ HCPT ＋ BLM ＋ DDP/CP 6 cases, FUDR ＋ HCPT ＋ EPI 7 cases, FUDR ＋ MMC ＋ CP 4 cases, 5 cases with L-OHP developed twice or more cholecystitis. The other 6 patients with hepatic cavernous hemangioma received BLM （mixed up with Lipiodol） only. Conclusions The incidence of post-TACE cholecystitis increases after opacification of cystic arteries and/or cholecysts on hepatic arteriography especially in those undertaken the therapeutic programs with DDP, BLM and L-OHP. Furthermore, the surpassing placement of the tips of the catheter with the origin of the cystic artery could prevent the occurrence of eholecystitis.
出处
《介入放射学杂志》
CSCD
2008年第4期251-254,共4页
Journal of Interventional Radiology
关键词
肝肿瘤
肝动脉栓塞
化疗
并发症
胆囊炎
Liver neoplasms
Embolization, hepatic artery
Chemotherapy, Cholecystitis
作者简介
通讯作者：杨继金
