摘要
目的 研究肝癌合并肝动脉门静脉瘘（HAPVF）时，门静脉压力升高的血液动力学改变，及由此导致的顽固性上消化道出血的诊断和治疗。方法 115例肝癌合并上消化道出血患者行肝动脉造影检查，其中严重HAPVF者用钢圈和（或）无水酒精行瘘口栓塞术。结果 本组84例一般性的上消化道出血者中，15例有轻度的HAPVF；31例顽固性上消化道出血肝癌患者中，26例有严重的HAPVF，差异有统计学意义（X^2=43．01，P〈0．01）。对此26例有严重的HAPVF患者行栓塞术后，DSA示血液分流减轻或消失，其中2例肝动脉主干闭塞。26例治疗后上消化道出血均停止。结论 肝癌出现顽固性上消化道出血时要考虑到可能有严重的HAPVF存在，肝动脉DSA可作出诊断。瘘口栓塞术是治疗此类型出血最有效的方法。
Objective To investigate the hemodynamics of increasing portal venous pressure（PVP） in bepatoceUular carcinoma patients complicated with hepatic arterioportal vein fistulas （HAPVF） and the diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by HAPVF. Methods One hundred and fifteen cases of hepatocenular carcinoma with upper gastrointestinal hemorrhage were checked by hepatic arteriography and were treated through orifices embolization in eases with severe HAPCF by coils and/or ethanol. Results Twenty-six out of 31 patients suffering intractable upper gastrointestinal hemorrhage have severe HAPVF （the main stem of portal veins are visible）. However, there are only 15 patients with light HAPVF among the 84 patients who have mild upper gastrointestinal hemorrhage （ the main stem of portal veins are invisible）. After the embolization, all of the 26 patients who have severe HAPVF stopped bleeding Among them, the main stem of hepatic arteries are occluded in 2 patients. Condusion The existence of severe HAPVF should be taken into consideration when intractable upper gastrointestinal hemorrhage occurs in hepatocellular carcinoma patients, and it can be diagnosed through hepatic artery DSA. Orifice embolization is the most effective method for such kind of hemorrhage.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第4期401-404,共4页
Chinese Journal of Radiology
关键词
癌
肝细胞
动静脉瘘
出血
栓塞
治疗性
Carcinoma, hpatocenular
Arterioportal fistula
Hemorrhage
Embolization, therapeutic
