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经导管动脉化疗栓塞术治疗肝细胞癌患者急性肾损伤的流行病学及管理

Epidemiology and Management of Acute Kidney Injury in Hepatocellular Carcinoma Patients Undergoing Transcatheter Arterial Chemoembolization.

作者信息

Hong Chen Xiao, Lv Lv Wen, Hua Liu Zhong, Bo Shen, Sen Cao Xue, Xin Nie Yu, Wei Yu Jia, Rui Xu Jia, Qiang Ding Xiao, Zhou Zou Jian

机构信息

Blood Purification Center, Zhongshan Hospital of Fudan University, 136 Yi Xue Yuan Road, Shanghai 200032. China.

出版信息

Curr Protein Pept Sci. 2017;18(12):1218-1223. doi: 10.2174/1389203717666160909124305.

Abstract

Transcatheter arterial chemoembolization (TACE) is an effective therapy for hepatocellular carcinoma (HCC). However, acute kidney injury (AKI) may occur after TACE due to the contrast agent and cytotoxic anticancer drugs used in this procedure. Post-TACE AKI is not an unusual event, and may adversely affect patient outcome. Coexisting situations including cirrhosis, renal insufficiency, diabetes and hypertension play a role in the development of HCC, and may predispose patients to AKI after TACE. Most post-TACE are transient and reversible, while prolonged AKI may predict a decreased survival. The best strategy to manage post-TACE AKI is prevention. Patients, before undergoing TACE, should be carefully assessed. In this study, we reviewed the current literature published in English about the incidence rate, risk factors, management and prognosis of AKI in patients with HCC undergoing TACE for a better understanding of this complication.

摘要

经动脉化疗栓塞术(TACE)是肝细胞癌(HCC)的一种有效治疗方法。然而,由于该手术中使用的造影剂和细胞毒性抗癌药物,TACE术后可能会发生急性肾损伤(AKI)。TACE术后AKI并非罕见事件,可能会对患者的预后产生不利影响。肝硬化、肾功能不全、糖尿病和高血压等并存情况在HCC的发生发展中起作用,可能使患者在TACE术后易发生AKI。大多数TACE术后的AKI是短暂且可逆的,而持续性AKI可能预示生存率降低。处理TACE术后AKI的最佳策略是预防。在进行TACE之前,应对患者进行仔细评估。在本研究中,我们回顾了以英文发表的关于接受TACE治疗的HCC患者AKI的发生率、危险因素、处理及预后的当前文献,以便更好地了解这一并发症。

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