目的评价用超选择性肝动脉栓塞术(TAE)治疗多囊肝(PLD)的长期疗效和安全性。方法对23例有严重症状的PLD患者进行超选择性肝动脉栓塞术。患者女19例,男4例,年龄36.0~68.0岁,平均(49.3±3.4)岁。所有患者在TAE前后行上腹部CT平扫+增强扫描:TAE后第3个月、第6个月及此后每间隔半年复查CT。结果23例患者共行27次介入治疗,手术技术成功率为100%,中位随访时间为19个月(3-58个月),2例无效,可供评价疗效者21例,有效率为91.2%。术前患者平均腹围为(105.7±8.1)cm,术后患者平均腹围为(95.2±6.7)cm,术前术后平均腹围具有统计学差异(P〈0.001)。平均腹围开始缩小时间(8.0±3.5)个月,症状改善时间(7.1±2.2)个月;栓塞后综合征多在栓塞术后7d内缓解,在术后第6天及长期复查肝功能均在正常水平。结论TAE治疗多囊肝,长期疗效可靠,安全性高,值得临床进一步推广应用。
Objective To evaluate the safety and long-term efficacy of transcatheter super-selective hepatic arterial embolization (TAE) for patients with polycystic liver disease (PLD). Methods A total of 23 patients with symptomatic PLD were enrolled. The patients consisted of nineteen women and four men [aged 36.0-68.0 years, mean age (49.3 ± 3.4)years]. All patients underwent contrast enhanced computed tomography (CT) scan of the liver before TAE and at every 3 months for the first half year after TAE, and at 6-monthly intervals thereafter. Results Follow-up was performed at a median of 19 months (range 3-58 months). 23 cases were treated by intervention 27 times, All procedures were successful without serious complications. TAE failed to benefit in 2 patients, but there were no complaints of worsening of the symptoms, available for 21 patients evaluable for efficacy, effective rate of 91.2%. The average preoperative abdominal circumference was ( 105.7± 8.1 ) cm, the average postoperative abdominal circumference was (95.2±6.7) era. After treatment average abdominal circumference reduction 10.1 cm (3.0-21.0 cm), statistically significant (P〈0.001). After treatment average abdominal circumference began to reduce time[(7.0± 3.5)mon], symptoms improved time [(9.1 ±4.2)mon]. Embolizafion syndrome returned to the normal range wilhin 1-7 day in all patients. Conclusion Transcatheter super-selective hepatic arterial embolization for patients with polycystic liver disease is a safe and long-term effective treatment for PLD patients, worthy of further clinical expand the application.