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The management of arteriovenous shunting in hepatocellular carcinoma
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 2
- DOI:
- 10.3760/j.issn:1005-1201.2002.02.006
- Key Word:
- 癌,肝细胞;动静脉瘘;栓塞,治疗性;乙醇
Abstract： 目的 研究肝癌介入治疗中对肝癌合并肝动脉肝静脉瘘和肝动脉门静脉瘘的处理方法.方法对50例肝动脉肝静脉瘘患者(A组)先行在瘘口附近多点、多次的经皮无水酒精注射消融术(PEI)后,再行经导管肝动脉栓塞术(TAE).对26例肝动脉门静脉瘘者(B组)则将超微导管头端越过瘘口后进行栓塞,再用带毛钢圈或无水乙醇封闭瘘口.结果 A组动静脉瘘消失及明显减少40例,无效10例.在消融后TAE碘油沉积良好的38例中,37例PEI 在4次以上.B组26例经1～2次治疗后,全部达到中止门静脉分流的目的 ,表现为TAE碘油沉积良好25例,门静脉压力明显下降,其中腹水减少23例,上消化道出血的2例均于术后1 d止血.结论上述2种方法处理肝癌合并动静脉瘘后,能令碘油药物更好地在肿瘤内沉积,避免或减少了碘油导致肺梗死或门静脉压进一步升高的危险性,提高了肝癌介入治疗的效果.
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