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目的 探讨经皮选择性隔离肝脏灌注化疗的可行性及隔离效果。方法 将 12只猪随机分为两组 :HAI组 6只 ,进行常规经肝动脉灌注化疗 ;PSIHP组 6只 ,利用介入放射学方法进行经皮选择性隔离肝脏灌注化疗结合血液灌流。化疗药物选用 5 -FU ,分别检测肝静脉及外周血液中的血药浓度。结果 HAI组肝静脉血 (过滤前 )和外周静脉血浓度峰值分别为 (4 15 3 4± 4 30 2 ) ,(16 76 1± 2 2 6 9)mg/L ;PSIHP组分别为 (5 2 19 7± 5 30 2 ) ,(6 5 7± 6 4 )mg/L。两组差异有显著性 (P <0 0 1)。PSIHP组过滤后肝静脉血血药浓度峰值为 (4 0 8 7± 4 7 8)mg/L ,碳肾率过滤达到 (78 2± 7 4 ) %。结论 PSIHP是一种简单有效的肝脏隔离灌注化疗技术 ,与常规经肝动脉灌注化疗相比 ,不仅可以增加局部血药浓度 ,更可以降低外周血血药浓度 ,降低毒副作用
Objective To investigate the feasibility and isolation effect of percutaneous selective hepatic infusion chemotherapy. Methods Twelve pigs were randomly divided into two groups: HAI group, conventional hepatic arterial infusion chemotherapy and six PSIHP group. Percutaneous selective hepatic perfusion chemotherapy combined with hemoperfusion was performed by interventional radiology. Chemotherapy drug selection 5-FU, were detected in the hepatic vein and peripheral blood plasma concentrations. Results The peak values of hepatic venous blood (before filtration) and peripheral venous blood in HAI group were (4 15 34 ± 4 30 2) and (16 76 1 ± 2 269) mg / L, respectively, and those in PSIHP group were 19 7 ± 5 30 2), (67 57 ± 6 4) mg / L. The difference between the two groups was significant (P <0.01). In the PSIHP group, the peak value of hepatic venous blood plasma concentration was (4087 ± 478) mg / L and the carbon filter rate was (78 2 ± 7 4)%. Conclusion PSIHP is a simple and effective technique of hepatic isolation and perfusion chemotherapy. Compared with conventional transcatheter arterial infusion chemotherapy, PSIHP can not only increase local blood concentration, but also reduce peripheral blood plasma concentration and reduce side effects