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食管静脉曲张破裂出血(EVB)是肝癌(HCC)肝动脉化疗栓塞(TAE)术后主要死亡原因之一,其严重影响TAE疗效,使远期生存率下降。1995-08/1999-06 HCC伴门脉高压食管静脉曲张行TAE者46例,探讨TAE术后近期EVB的防范如下。 1 材料和方法 1.1 材料住院经B超,CT及AFP等检查诊断为HCC不能或不愿手术者46例,内镜证实食管静脉曲张,根据Palmer分类,食管静脉曲张程度属中度8例,重度38例,其中红线征33例。全部病例1mo内无出血史,按入院先后分为治疗组及对照组,每组各为23例,治疗组男15例,女8例,年龄35岁～71岁,平均62岁;对照组男17例,女6例,年龄38岁～68岁,平均61岁。 1.2 方法全部病例经肝动脉途径治疗HCC均适合选TAE术,采用Seldinger技术,行右侧股动脉穿刺超选择肝固有动脉
Esophageal variceal hemorrhage (EVB) is one of the main causes of death after hepatic arterial chemoembolization (TAE) in hepatocellular carcinoma (HCC). It severely affects the efficacy of TAE and reduces the long-term survival rate. 1995-08/1999-06 46 cases of HCC with portal hypertension and esophageal varices underwent TAE. To investigate the prevention of EVB in the near future after TAE. 1 Materials and methods 1.1 Materials hospitalized by B-ultrasound, CT and AFP and other tests were diagnosed as HCC can not or unwilling to operate in 46 cases, endoscopic examination of esophageal varices, according to Palmer classification, esophageal varices are moderate in 8 cases, severe 38 cases, including 33 cases of red lines. All patients had no history of bleeding within 1 month. They were divided into treatment group and control group according to the admissions. There were 23 cases in each group. The treatment group included 15 males and 8 females, aged from 35 to 71 years old, with an average of 62 years old. 17 cases, 6 women, aged 38 to 68 years, mean 61 years old. 1.2 Methods HCC treated with hepatic artery in all cases was suitable for TAE. Seldinger technique was used to perform right femoral artery puncture and superselective hepatic artery