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[局部乙醇注射疗法治疗肝脏血管瘤病的长期疗效]

[Long-term results of local ethanol injection therapy in the treatment of hemangiomatosis of the liver].

作者信息

Veriasova N N, Polysalov V N, Tarazov P G

出版信息

Vestn Khir Im I I Grek. 2003;162(3):22-6.

Abstract

During the period from 1989 till 1998 local ethanol injection therapy (LEIT) was used in treatment of 37 patients aged 39-78. The multiple focused form of hemangioma of the liver was observed in 15 (41%) patients, solitary in 20 (54%), the diffuse-focused in 2 (5%) patients. The distribution of the tumors according to the histological structure was as follows: cavernous hemangioma in 22 (60%) patients, capillary--in 2 (5%) patients, mixed in 13 (35%). Local injection therapy was the only method of treatment of 17 patients. In 13 patients this method gave insufficiently effective embolization of the hepatic artery, in 2 patients the injection therapy was combined with ligation of the hepatic artery and in 5 patients--with resection of the liver because of another tumor. The volume of a single use of ethanol varied from 6 to 60 ml. Long-term results were followed-up during 3-6 years. By the data of USI, CT, NMR in all the patients there were changes in the tumor typical of fibrosis. Positive results of the treatment such as a reduced size of hemangioma were noted in 27 patients (73.0%), pains disappeared in 10 out of 29 patients (35%) who had pain syndrome. A conclusion is made that local ethanol injection therapy with 96% ethyl alcohol is effective in treatment of hemangioma of the liver. It gives good long-term results including a combination with the endovascular treatment and resection of the liver.

摘要

1989年至1998年期间,采用局部乙醇注射疗法(LEIT)治疗了37例年龄在39至78岁之间的患者。观察到15例(41%)患者为肝脏血管瘤的多发聚焦型,20例(54%)为单发,2例(5%)为弥漫聚焦型。根据组织学结构,肿瘤分布如下:海绵状血管瘤22例(60%),毛细血管型2例(5%),混合型13例(35%)。局部注射疗法是17例患者的唯一治疗方法。13例患者中,该方法对肝动脉的栓塞效果不佳;2例患者的注射疗法与肝动脉结扎相结合;5例患者因其他肿瘤而行肝脏切除术。单次使用乙醇的量为6至60毫升。随访3至6年观察长期疗效。根据超声成像(USI)、计算机断层扫描(CT)、核磁共振(NMR)的数据,所有患者的肿瘤均出现了典型的纤维化改变。27例患者(73.0%)出现了如血管瘤体积缩小等治疗阳性结果,29例有疼痛综合征的患者中,10例(35%)疼痛消失。得出结论:用96%乙醇进行局部乙醇注射疗法对肝脏血管瘤治疗有效。该方法能取得良好的长期疗效,包括与血管内治疗及肝脏切除术联合使用。

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