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【目的】观察Embosphere微粒球经动脉途径栓塞治疗富血供肿瘤的疗效和安全性。【方法】回顾性分析2015年9月至2016年2月共73例富血供肿瘤患者,其中肺部肿瘤11例,腹部肿瘤53例,子宫附件肿瘤9例,肿瘤伴发出血25例,全部患者均采用经导管灌注Embosphere微粒球的方法栓塞肿瘤血管,术中通过数字减影血管造影检查评估栓塞前及栓塞后目标肿瘤的供血情况,通过CT/MR增强扫描对比观察目标瘤灶术后1个月体积变化及血供情况,评估目标瘤灶的临床疗效,临床观察患者术后有无异位栓塞并发症和不良反应。【结果】患者术后1个月复查CT/MR提示目标瘤灶体积较术前均明显缩小,差异有统计学意义(P<0.05),临床有效率100%(73/73),肿瘤并出血患者首次介入栓塞后出血停止22例,栓塞后再次出血3例,表现为反复咯血,复发原因为肿瘤存在多支供血动脉,再次栓塞成功止血;出现异位栓塞2例,并发症率2.7%(2/73),不良反应主要为疼痛、发热,经止痛、退热对症处理后症状均可缓解。【结论】Embosphere微粒球经动脉栓塞治疗富血供肿瘤近期疗效显著,中远期疗效有待进一步观察,超选择性肿瘤血管栓塞是减少异位栓塞严重并发症的有效方法,值得临床推广应用。
【Objective】 To observe the efficacy and safety of Embosphere pellets treated by arterial embolization for blood-rich tumor. 【Methods】 A total of 73 blood-rich patients with cancer were retrospectively analyzed from September 2015 to February 2016. Among them, 11 were pulmonary tumors, 53 were abdominal tumors, 9 were uterine accessory tumors, and 25 were tumor-associated hemorrhages Patients were embolized by embedding sphere embosphere tumor vessels, intraoperative digital subtraction angiography to assess the pre-embolic and post-embolization target tumor blood supply, contrast enhanced CT / MR observation of the target tumor after surgery 1 Month volume changes and blood supply, assess the clinical efficacy of the target tumor, clinical observation of patients with or without ectopic embolism complications and adverse reactions. 【Results】 The results of CT / MR examination at 1 month after operation showed that the volume of target tumor was significantly reduced compared with that before operation (P <0.05), and the clinical effective rate was 100% (73/73). The tumor and hemorrhage Hemorrhage was stopped in 22 patients after embolization for the first time, and hemorrhage occurred again in 3 patients after embolization. The recurrence was due to repeated hemoptysis. The recurrence was due to the presence of multiple blood supply arteries in the tumor and successful hemostasis by embolization. In 2 patients with ectopic embolization, the complication rate was 2.7% 2/73), the main adverse reactions were pain, fever, pain relief, fever symptoms can be relieved symptomatically. 【Conclusion】 The embosphere pellet treated by arterial embolization has obvious curative effect in the treatment of blood-rich tumor. The curative effect of long-term and long-term treatment remains to be further observed. The super selective tumor angiography is an effective method to reduce the serious complications of ectopic embolization, which is worthy of clinical application.