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肝动脉门静脉双重栓塞术治疗肝癌对肝脏储备功能的影响 被引量:7

Impact of Combined Hepatic Arterial and Portal Venous Embolization on Hepatic Functional Reserve
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摘要 10例原发性肝癌患者经腹脉动脉门静脉双重插管,同时化疗栓塞,并观察了术前术后肝脏储备功能指标的变化。10例患者的肝实质栓塞率在8.36%~47.8%。其中4例接近或超过40%,血浆中cAMP基础浓度,术前术后相比无显著变化,P>0.05,经胰高血糖素负荷后,cAMP浓度从术前的278.31降至术后的142.38pmol/ml,P<0.05,4例术后cAMP明显低下(小于90pmol/ml);患者术前肝动脉门静脉血流灌注指数与肝硬化时改变相似,8例中2例肝动脉门静脉血流均增加,3例肝动脉血流增加,门静脉减少,另外3例则相反;3例栓塞率较高。负荷后cAMP低下者出现了一过性黄疸和腹水。结果表明:①双重栓塞可损害一部分肝实质,对肝脏储备功能产生一定影响,但尚在代偿范围之内;②双栓范围较大,cAMP低下时注意保护功能;③双栓后肝血流的变化复杂,应进一步研究必手术操作简便,方法可靠安全。 The changes in hepatic functional reserve of 10 patients with liver cancer who underwent combined transabdominal hepatic arterial and portal venous chemoembolization were observed. The parenchymal hepatic embolization rate (PHER) was 8. 36%-47. 8% in this series in which 4 yielded a PHER of nearly 40%. There was no significant difference in cAMP contents before glucagon loading between pre-and post-embohzation(P>0.05).However, after glucagon hading the cAMP contents decreased following embolization from 278. 31 pmol/ml to 142. 38 pmol/ml(P<0. 05). Three patients developed transient jaundice and ascites after combined embolization procedure.Before embolization the blood flow indexes of liver were similar to that of the cirrhosis.After embolization two of me 8 cases had an increase of both the hepatic artery and portal venous blood flow.And,3 of the 8 cases showed reduction in portal venous blood flow but increase of the hepatic arterial flow.And,the other three were on the contrary.In conclusion:(1)patients with liver cirrhosis tolerated fairly well with the combined embolization,(2)the procedure may damage some hepatic parenchyma but does not result in serious complications and the impaired liver function can be compensated completely,(3)with marked lowering cAMP value attention should be paid to status of liver function,(4)the Changes of the liver blood flow should be studied further.
出处 《中国肿瘤临床》 CAS CSCD 北大核心 1996年第1期35-38,共4页 Chinese Journal of Clinical Oncology
关键词 肝肿瘤 肝脏储备功能 肝动脉 门静脉 栓塞术 Primary hepatic carcinoma Embolization Heeatic functional reserve
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参考文献2

  • 1王更才,中华消化杂志,1992年,12卷,270页
  • 2赵周社,中华核医学杂志,1991年,11卷,115页

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