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目的 探讨经皮局部隔离肝脏灌注化疗的方法及可行性。方法 12只实验用犬 ,对照组 4只 ,进行常规经肝动脉灌注化疗 ;实验组 8只 ,利用介入放射学方法进行经皮局部隔离肝脏灌注化疗结合血液灌流。化疗药物选用阿霉素 ,分别检测肝静脉及外周血液中的血药浓度。结果 实验组介入操作全部成功 ,1例死于血液灌流的血路管漏气 ,平均操作时间 ( 132 .3± 15 .3)min。血药浓度测定显示 ,对照组肝静脉血和外周静脉血浓度峰值分别为 ( 370 9.676± 385 .72 3)ng/ml、( 15 76.14 0± 2 2 6.933)ng/ml;实验组为( 465 3.42 0± 430 .2 0 4)ng/ml、( 433.612± 40 .5 0 1)ng/ml。统计学处理 ,两组相差非常显著。结论 经皮局部隔离肝脏灌注化疗结合血液灌流是一种可行的技术 ,具有简单、创伤小、可保护正常肝脏、便于重复治疗的优点。与常规经肝动脉灌注化疗相比 ,不仅可以增加局部血药浓度 ,更可以降低外周的血药浓度 ,降低毒副作用
Objective To investigate the method and feasibility of percutaneous local isolation of hepatic infusion chemotherapy. Methods Twelve experimental dogs were used in the control group and four rats in the control group were treated with conventional hepatic arterial infusion chemotherapy. In the experimental group, eight rabbits in the experimental group were treated with percutaneous percutaneous transhepatic perfusion chemotherapy combined with hemoperfusion by interventional radiology. Doxorubicin was used as a chemotherapeutic agent to detect plasma concentrations in hepatic veins and peripheral blood. Results The interventional operation of the experimental group was all successful. One patient died of blood leakage from the blood tube in hemoperfusion. The average operation time was (132.3±15.3)min. Blood concentration determination showed that the peak concentrations of hepatic venous blood and peripheral venous blood in the control group were (370 9.676± 385.72 3) ng/ml and (15 76.14 0± 2 2 6.933) ng/ml respectively; the experimental group was (465 3.42 0 ± 430.2 0 4) ng/ml, (433.612 ± 40.50 1) ng/ml. Statistical treatment, the difference between the two groups is very significant. Conclusion Percutaneous local isolation of hepatic perfusion chemotherapy combined with perfusion of blood is a feasible technique. It has the advantages of simplicity, less trauma, protection of normal liver, and easy retreatment. Compared with conventional hepatic arterial infusion chemotherapy, not only can increase the local plasma concentration, but also can reduce the peripheral blood concentration, reduce toxic side effects.