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目的 :了解肾癌血管造影表现以及肾癌术前经肾动脉化疗栓塞的临床意义。方法 :18例肾癌患者中经肾动脉行普通血管造影 6例 ,行DSA血管造影 12例。在血管造影的同时 ,根据肿瘤大小、部位以及肾门淋巴结转移情况 ,经供瘤动脉给予三联化疗药物 ,再用适量碘化油乳剂及明胶海绵条给予栓塞。栓塞后 2～ 7天内行患肾全切除手术。结果 :血管造影显示供瘤动脉增粗 ,血流明显加快 ;可见肾肿瘤血管及肿瘤染色 ;肾脏轮廓改变 ,肾门移位 ,肾脏表面凹凸不平 ;肾动—静脉瘘形成以及肾静脉癌栓的形成。化疗栓塞后行肾脏全切除手术 ,术中出血量少 ,肾肿瘤周围明显形成水肿带 ,易于剥离切除 ;减少术中种植转移的可能。结论 :肾癌术前经皮穿刺肾动脉化疗栓塞对减轻临床症状 ,改善手术条件 ,提高生存质量 ,延长生存时间都具有非常重要的积极意义。
Objective: To investigate the clinical manifestations of renal carcinoma angiography and renal artery chemoembolization before renal cell carcinoma. Methods: 18 patients with renal cell carcinoma underwent routine angiography through the renal artery in 6 cases, DSA angiography in 12 cases. Angiography at the same time, according to the size of the tumor, site and lymph node metastasis of renal hilar, given by the tumor artery triple chemotherapy drugs, and then the appropriate amount of iodized oil emulsion and gelatin sponge embolization. 2 to 7 days after embolization with renal total resection surgery. Results: Angiography showed the thickening of the arteries and blood flow significantly; visible renal tumor vessels and tumor staining; changes in the outline of the kidney, renal door shift, uneven surface of the kidney; renal arteriovenous fistula formation and renal vein tumor thrombus form. Chemoembolization after the line of total excision of the kidney surgery, less blood loss, renal tumor was significantly formed around the edema zone, easy to peel resection; to reduce the possibility of surgical implantation. Conclusion: Preoperative percutaneous renal artery chemoembolization for renal cell carcinoma has very important positive significance in reducing clinical symptoms, improving surgical conditions, improving quality of life and prolonging survival time.