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目的 探讨四氧化三铁 (Fe3 O4)微粒栓塞肿瘤及血管性疾病临床应用价值。方法 临床 10 6例患者 ,采用Seldinger技术插管 ,置导管端于靶血管内 ,在X线电视监测下 ,用Fe3 O4微粒或Fe3 O4化疗药物混悬液栓塞。结果 恶性肿瘤 94例 ,良性血管性病变 12例 ,多数患者栓后 1月CT、USG或DSA复查 ,肿瘤明显缩小。 18例肿瘤栓塞后手术切除 ,病理检查 :肿瘤组织坏死 10 0 %。血生化检查 :肝肾功能有轻度变化 ,经一般临床处理可接近栓塞前正常水平或优于术前水平。原发性肝癌栓塞后血清AFP多数有明显下降 ,血清铁浓度栓塞前后变化显示 :Fe3 O4微粒栓塞治疗有助于血清铁浓度指标正常值的维持。栓塞前后DSA对照显示 ,1月后Fe3 O4微粒由栓塞动脉血管近端移向远端末梢 ,临床观察栓后综合征明显下降。结论 通过 10 6例患者临床栓塞治疗 ,Fe3 O4微粒是一种理想的永久性颗粒栓塞剂。
Objective To investigate the clinical value of Fe3O4 particle embolization in tumor and vascular diseases. Methods A total of 106 patients underwent catheterization with Seldinger technique. The catheter end was placed in the target vessel and embolized with Fe3 O4 particles or Fe3 O4 chemotherapeutic drug suspension under X-ray television monitoring. Results 94 cases of malignant tumors, benign vascular lesions in 12 cases, most patients in January after CT, USG or DSA review, the tumor was significantly reduced. 18 cases of tumor resection after surgery, pathological examination: tumor necrosis 10 0%. Blood biochemical tests: mild changes in liver and kidney function, the general clinical treatment can be close to the normal level before embolization or better than the preoperative level. Most of serum AFP in patients with primary hepatic carcinoma was significantly decreased. The changes of serum iron concentration before and after embolization showed that the treatment of Fe3 O4 particles helped to maintain the normal serum iron concentration. Before and after embolization DSA control showed that after 1 month Fe3 O4 particles from the proximal arterial embolization to the distal tip, the clinical observation of post-suppository syndrome decreased significantly. Conclusion Fe 10 O 4 particles are an ideal permanent particle embolization agent through clinical embolization of 106 patients.