Tasneem Abbas Ali, Abbas Zaigham, Luck Nasir Hassan, Hassan Syed Mujahid, Faiq Syed Muhammad
Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SLUT), Karachi, Pakistan.
J Pak Med Assoc. 2013 Feb;63(2):239-44.
To document the adverse events after transarterial chemoembolisation and factors predicting such events.
The prospective observational study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, from November 2009 to November 2011. All patients diagnosed as hepatocellular carcinoma were included in this study. Complications developing within the first 6 weeks of the procedure were recorded. SPSS version 16 was used for statistical analysis.
Of the total 80 patients, 59 (73.8%) were male. The overall mean age was 52.25 +/- 9.24 (range: 28-76 years). Most common etiology was hepatitis C related cirrhosis in 55 (68.8%). Adverse events developed in 46 (57.5%) patients. Post transarterial chemoembolisation syndrome was seen in 37 (46.3%). Of those with the syndrome, 24 (64.8%) patients had no additional complications, while 3 (8%) had renal dysfunction, 2 (5%) hypertensive crisis, and 1 (2.7%) patient each had urinary tract infection, pneumonia and sepsis. Decompensation of cirrhosis occurred in 6 (7.5%) patients of whom 3 (50%) developed sepsis and died. The syndrome was associated with tumour size > 5cm (p = 0.001) and higher dose of lipoidol (p = 0.0001). Decompensation of cirrhosis was associated with low basal albumin (p = 0.002), advanced basal child turcotte pugh (p = 0.005) and model for end-stage liver disease (p = 0.006) scores.
Transarterial chemoembolisation, though generally safe, may lead to serious complications in patients with advanced liver disease. Post-procedure syndrome was associated with increased tumour size and lipoidol dose.
记录经动脉化疗栓塞术后的不良事件及预测此类事件的因素。
2009年11月至2011年11月在卡拉奇的信德泌尿与移植研究所进行了前瞻性观察研究。本研究纳入了所有诊断为肝细胞癌的患者。记录在该操作的前6周内发生的并发症。使用SPSS 16版进行统计分析。
在总共80例患者中，59例（73.8%）为男性。总体平均年龄为52.25±9.24岁（范围：28 - 76岁）。最常见的病因是丙型肝炎相关肝硬化，共55例（68.8%）。46例（57.5%）患者发生了不良事件。37例（46.3%）出现了经动脉化疗栓塞术后综合征。在患有该综合征的患者中，24例（64.8%）没有其他并发症，而3例（8%）出现肾功能障碍，2例（5%）出现高血压危象，各有1例（2.7%）患者发生尿路感染、肺炎和败血症。6例（7.5%）患者出现肝硬化失代偿，其中3例（50%）发生败血症并死亡。该综合征与肿瘤大小>5cm（p = 0.001）和更高剂量的碘油（p = 0.0001）相关。肝硬化失代偿与低基础白蛋白（p = 0.002）、晚期基础Child - Turcotte - Pugh（p = 0.005）和终末期肝病模型（p = 0.006）评分相关。
经动脉化疗栓塞术虽然总体安全，但可能会在晚期肝病患者中导致严重并发症。术后综合征与肿瘤大小增加和碘油剂量有关。
