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目的总结平阳霉素碘油乳剂行肝动脉硬化栓塞术(TAE)治疗的肝血管瘤的疗效和优缺点。方法对150例肝血管瘤患者,采用平阳霉素碘油乳剂超选择性动脉插管行硬化栓塞治疗,观察治疗前和治疗后3、6个月时患者临床症状、肿瘤大小的变化以及出现的并发症。结果所有患者在术后3、6个月复查CT,见瘤体血供消失,其内碘油沉积良好,并出现瘤体缩小、碘化油聚积征象。术前血管瘤直径平均(8.47±2.27)cm,术后3、6个月血管瘤直径分别平均(5.75±1.40)cm和(3.51±0.82)cm(P<0.05)。治疗前有临床症状者治疗后缓解或消失。术后均未出现胆囊坏死、胆管狭窄和肝坏死等严重并发症。结论肝动脉平阳霉素碘油乳剂栓塞治疗肝血管瘤是一种安全、有效、微创的非手术治疗方法。治疗效果明显,其硬化性栓塞与药理作用是一种较为理想的栓塞方案。
Objective To summarize the curative effect and advantages and disadvantages of hepatic hemangioma treated with bleomycin lipiodol emulsion and hepatic arteriosclerosis embolization (TAE). Methods 150 patients with hepatic hemangiomas were treated with PYM lipiodol emulsion with hypersensitivity arterial catheterization. The changes of clinical symptoms and tumor size before and 3 and 6 months after treatment were observed, complication. Results All patients underwent CT scan 3 and 6 months after operation. See the disappearance of the blood supply in the tumor. The iodized oil was well deposited in the patient, and the shrinkage of the tumor and the accumulation of iodized oil appeared. The mean diameter of preoperative hemangiomas was (8.47 ± 2.27) cm, and the mean diameters of hemangiomas were 5.75 ± 1.40 cm and 3.51 ± 0.82 cm (P <0.05) at 3 and 6 months after operation. Before treatment, clinical symptoms were relieved or disappeared after treatment. No postoperative gallbladder necrosis, bile duct stricture and liver necrosis and other serious complications. Conclusion Hepatic artery Pingyangmycin lipiodol emulsion embolization for the treatment of hepatic hemangiomas is a safe, effective and minimally invasive non-surgical treatment. The treatment effect is obvious, the sclerotic embolization and pharmacological effect is a more ideal embolization scheme.