Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K, Iwanaga S, Mori M, Morikawa M, Fukuda T, Hayashi K, Matsunaga N
Department of Radiology, Nagasaki University School of Medicine, Japan.
Radiographics. 1998 May-Jun;18(3):605-19. doi: 10.1148/radiographics.18.3.9599386.
Transcatheter arterial embolization (TAE) is widely used in the treatment of hepatic tumors. A total of 2,300 TAE procedures were performed with a 2-15-mL injection of a mixture or suspension of anticancer drugs and iodized oil, followed by administration of gelatin sponge particles. One or two chemotherapeutic drugs, including doxorubicin hydrochloride (10-30 mg), epirubicin hydrochloride (10-30 mg), mitomycin C (10-20 mg), and cisplatin (25-100 mg), were used for each procedure. Complications were encountered in 4.4% of cases (n = 102) and were related to the use of chemoembolic agents or the manipulation of a catheter or guide wire. These complications included acute hepatic failure (n = 6), liver infarction (n = 4) or abscess (n = 5), intrahepatic biloma (n = 20), multiple intrahepatic aneurysms (n = 6), cholecystitis (n = 7), splenic infarction (n = 2), gastrointestinal mucosal lesions (n = 5), pulmonary embolism or infarction (n = 4), tumor rupture (n = 1), variceal bleeding (n = 3), and iatrogenic dissection (n = 35) or perforation (n = 4) of the celiac artery and its branches. Knowledge of these complications is important for correct diagnosis and appropriate management.
经导管动脉栓塞术(TAE)广泛应用于肝肿瘤的治疗。共进行了2300例TAE手术,向瘤体注射2 - 15毫升抗癌药物与碘化油的混合物或混悬液,随后注入明胶海绵颗粒。每次手术使用一种或两种化疗药物,包括盐酸多柔比星(10 - 30毫克)、盐酸表柔比星(10 - 30毫克)、丝裂霉素C(10 - 20毫克)和顺铂(25 - 100毫克)。4.4%的病例(n = 102)出现了并发症,这些并发症与使用化疗栓塞剂或导管及导丝操作有关。这些并发症包括急性肝衰竭(n = 6)、肝梗死(n = 4)或肝脓肿(n = 5)、肝内胆汁瘤(n = 20)、多发肝内动脉瘤(n = 6)、胆囊炎(n = 7)、脾梗死(n = 2)、胃肠道黏膜病变(n = 5)、肺栓塞或梗死(n = 4)、肿瘤破裂(n = 1)、静脉曲张出血(n = 3)以及腹腔动脉及其分支的医源性夹层(n = 35)或穿孔(n = 4)。了解这些并发症对于正确诊断和恰当处理非常重要。