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肝肿瘤经导管动脉栓塞术相关并发症。

Complications associated with transcatheter arterial embolization for hepatic tumors.

作者信息

Sakamoto I, Aso N, Nagaoki K, Matsuoka Y, Uetani M, Ashizawa K, Iwanaga S, Mori M, Morikawa M, Fukuda T, Hayashi K, Matsunaga N

机构信息

Department of Radiology, Nagasaki University School of Medicine, Japan.

出版信息

Radiographics. 1998 May-Jun;18(3):605-19. doi: 10.1148/radiographics.18.3.9599386.

Abstract

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.

摘要

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。

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