实用肝脏病杂志 ›› 2015, Vol. 18 ›› Issue (6): 651-654.doi: 10.3969/j.issn.1672-5069.2015.06.021

• 肝癌 • 上一篇    下一篇

明胶海绵颗粒与Embosphere生物微球栓塞治疗原发性肝癌破裂出血对比观察

杨均, 崔红利, 颜綦先, 肖潇, 周银斌, 潘大维, 李丽, 尹昕茹, 陈东风, 王军   

  1. 400042 重庆市 第三军医大学大坪医院野战外科研究所消化内科
  • 收稿日期:2015-03-20 出版日期:2015-11-20 发布日期:2016-02-04
  • 通讯作者: 王军,E-mail:wjun_7311@126.com
  • 作者简介:杨均,男,40岁,副主任医师。主要研究方向:慢性肝病和消化道肿瘤血管介入及镜下治疗。E-mail:yangjun5066@sina.com

Comparison of gelatin sponge particle and embosphere microsphere embolization in treatment of patients with spontaneous rupture of hepatocellular carcinoma

Yang Jun, Cui Hongli, Yan Qixian, et al.   

  1. Research Institute of Surgery,Department of Gastroenterology,Daping Hospital,Third Military Medical University,Chongqing 400042,China
  • Received:2015-03-20 Online:2015-11-20 Published:2016-02-04

摘要: 目的探讨明胶海绵颗粒与Embosphere生物微球栓塞治疗原发性肝癌破裂出血的效果。方法回顾分析近5年来收治的49例(使用明胶海绵23例,使用Embosphere生物微球26例)经导管肝动脉明胶海绵和Embosphere生物微球栓塞治疗的原发性肝癌破裂出血患者的临床资料,评价即时止血和再次出血率。结果明胶海绵组和Embosphere生物微球组即时止血率均为100%;在明胶海绵栓塞治疗后7天内再次出血率为13.0%(3/23),1例转外科手术,1例再次介入治疗,术后成功止血,1例因突发失血性休克死亡;在Embosphere生物微球栓塞后7天内再次出血率为3.8%(1/26),显著低于明胶海绵组(P<0.01)。结论明胶海绵和Embosphere生物微球治疗肝癌破裂出血即时止血效果相同,但Embosphere生物微球治疗术后再出血风险明显减少。

关键词: 原发性肝癌, 破裂出血, 明胶海绵颗粒, Embosphere生物微球, 肝动脉栓塞术

Abstract: Objective To explore the efficacy of the gelatin sponge particle and embosphere microsphere embolization for the treatment of patients with hepatocellular carcinoma and tumor rupture. Methods 49 patients with rupture of hepatocellular carcinoma underwent transcatheter arterial embolization by gelatin sponge particle (n=23) or embosphere microsphere(n=26) embolization in recent 5 years,and instant hemostatic and rehaemorrhagia rates were compared. Results There was no difference between gelatin sponge particle and embosphere microsphere embolization on the effects of instant hemostatic(both were 100%);Seven days after intervention,the rehaemorrhagia rate in gelatin sponge particles was 13.0%(3/23),one patient was transferred to surgery,one patient was re-intervened and one patient dead because of haemorrhagic shock,respectively;The rehaemorrhagia rate in embosphere microspheres group was 3.8%(1/26,P<0.01),and the patient received re-intervention and the bleeding was stopped successfully. Conclusion The instant hemostatic effect is the same between the gelatin sponge particle and embosphere microspheres embolization in patients with rupture of hepatocellular carcinoma,however,the embosphere group has much less chance to rebleeding within 7 days.

Key words: Hepatocellular carcinoma, Spontaneous Rupture, Gelatin sponge particles, Embosphere Microsphere, Transcatheter arterial embolization