摘要
目的研究血供类型对肝血管瘤(HL)患者介入栓塞后3年疗效的影响。方法选取2016年7月-2019年7月河南大学附属南阳市第一人民医院收治的75例HL患者为研究对象,根据患者血供类型分为A组(富血供,n=25)、B组(中等血供,n=28)与C组(乏血供,n=22),所有患者均行介入栓塞治疗,随访3年。比较三组患者术后6个月、12个月、36个月的临床疗效、病灶最大直径、肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBil)]水平。结果与术前相比,三组患者各时点病灶直径均显著缩小,其中A组[(9.41±1.81)、(5.71±0.94)、(2.91±0.26)、(2.74±0.21)cm]、B组[(9.52±1.87)、(5.87±1.03)、(3.29±0.38)、(2.89±0.27)cm]、C组[(9.39±1.87)、(7.17±1.55)、(6.53±0.78)、(6.15±0.63)cm(P<0.05)];术后不同时点疗效比较,A组(64.00%、80.00%、88.00%)、B组(64.29%、67.86%、78.57%)均高于C组(22.73%、31.82%、31.82%),术后病灶直径A组、B组均小于C组(P<0.05);三组患者术后不同时点ALT、TBil比较差异无统计学意义(P>0.05);三组术后均出现恶心呕吐、发热、疼痛等一般并发症,富血供组出现肝损伤2例,肝脓肿1例;中等血供组出现肝损伤2例,胆道损伤1例;乏血供组出现肝损伤2例,经对症处理后均恢复正常。结论介入栓塞治疗不同血供类型HL患者疗效不同,用于富血供型或中等血供型治疗时效果较好,但用于乏血供型时患者无明显变化,但血供类型未对HL患者介入栓塞治疗后并发症及肝功能造成影响。
Objective To investigate the effect of different blood supply types on the three-year efficacy of interventional embolism of patients diagnosed with hepatic hemangioma(HL).Methods A total of 75 HL patients admitted from July 2016 to July 2019 were enrolled as the study subjects and were divided into group A(rich blood supply,n=25),group B(moderate blood supply,n=28)and group C(deficient blood supply,n=22)according to the type of blood supply,and all patients underwent interventional embolism and were followed up for 3 years post-procedure.Clinical efficacy,maximum lesion diameter,and liver function metrics,including alanine aminotransferase(ALT)and total bilirubin(TBil)]levels,were compared among the three groups at 6,12,and 36-month post-procedure.Results Compared with pre-operation measurements,the diameter of the lesion was significantly reduced post-operation in Group A(9.41±1.81,5.71±0.94,2.91±0.26,2.74±0.21,respectively),Group B(9.52±1.87,5.87±1.03,3.29±0.38,2.89±0.27,respectively),and Group C(9.39±1.87,7.17±1.55,6.53±0.78,6.15±0.63,respectively)(P<0.05);The postoperative efficacy rates in Group A(64.00%,80.00%,88.00%)and Group B(64.29%,67.86%,78.57%)were notably higher than in Group C(22.73%,31.82%,31.82%).Moreover,the postoperative diameters of lesions in groups A and B were lower than that in group C(P<0.05).No significant differences were observed in ALT and TBIL among the three groups at different postoperative time points(P>0.05).Postoperative complications,such as nausea,vomiting,fever,and pain were reported in all three groups.The rich blood supply group reported 2 cases of Liver injury and one case of liver abscess.The moderate blood supply group reported 2 cases of liver injury and 1 case of biliary duct injury.The deficient blood supply group reported 2 cases of liver injury,and all complications were successfully managed with symptomatic treatment.Conclusion The therapeutic effect of interventional embolization varies among HL patients with different types of blood supply.Specifically,patients with a rich or moderate blood supply tend to experience therapeutic outcomes,while those with a deficient blood supply have less favorable results.However,the type of blood supply does not appear to influence the complications or liver function in HL patients following interventional embolization.
作者
韩廷超
王忠
申梦圆
唐梦歌
余进松
HAN Ting-chao;WANG Zhong;SHEN Meng-yuan;TANG Meng-ge;YU Jin-song(Department of Radiology,Nanyang First People′s Hospital Affiliated to Henan UniversityHenan,473000,China;Department of General Surgery,Nanyang First People′s Hospital Affiliated to Henan University,,Henan,473000,China)
出处
《肝脏》
2023年第7期833-836,共4页
Chinese Hepatology
基金
河南省医学科技攻关计划项目(LHGJ20200902)。
关键词
血供类型
肝血管瘤
介入栓塞术
肝功能
Blood supply type
Hepatic hemangioma
Interventional embolization
Liver function
