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目的 探讨肝胆系统非血管性介入放射学中并发症发生的原因、预防及其处理。材料与方法 45 3例行经导管碘油抗癌药乳化剂栓塞化疗 (TOCE)后的肝癌残余癌灶接受经皮无水乙醇注射治疗 (PEI) ,每次经 2 2F穿刺针注入无水乙醇 6～ 3 0ml,平均12ml。每周行PEI 1～ 2次 ,每例共行 3～ 2 0次 ,平均 6.5次。 2 2 1例阻塞性黄疸患者行经皮肝胆道穿刺引流 (PTBD) ,其中 48例引流 1～ 2天后行胆道支架置入术 (PTBS)。支架直径 10mm ,长度 4～ 8cm。 43例放置 1枚 ,5例放置 2枚。结果 PEI中的并发症包括胆管损伤 5例 ,占 1.1% ;乙醇碘油外溢 8例 ,占 1.8% ;肝功能衰竭 1例 ,占 0 .2 %。PTBD的并发症为肋间动脉损伤出血 1例 ,占 0 .5 % ;PTBS的并发症为肝脓肿 2例 ,占 4.2 %。结论 以上并发症的发生概率表明肝胆系统非血管性介入放射技术是安全的 ,通过发生原因的分析 ,其预防和处理是可以做到的。
Objective To investigate the causes, prevention and treatment of complications in hepatobiliary system non-vascular interventional radiology. MATERIALS AND METHODS 45 3 cases of residual liver cancer after TOEC treated with lipiodol anticancer drug were treated with percutaneous ethanol injection (PEI) 6 ~ 3 0ml, an average of 12ml. Per PEI 1 to 2 times a week, each case a total of 3 to 20 times, an average of 6.5 times. Twenty - two patients with obstructive jaundice underwent percutaneous transhepatic biliary puncture (PTBD), 48 of whom underwent biliary stenting (PTBS) 1 to 2 days after drainage. Stent diameter 10mm, length 4 ~ 8cm. 43 cases placed 1, 5 cases placed 2. Results Complications in PEI included bile duct injury in 5 cases, accounting for 1.1%; ethanol-iodized oil spilled in 8 cases, accounting for 1.8%; liver failure in 1 case, accounting for 0.2%. The complication of PTBD was bleeding of intercostal artery in 1 case, accounting for 0.5%. The complications of PTBS were liver abscess in 2 cases, accounting for 4.2%. Conclusion The above complication probability indicates that non-vascular interventional radiotherapy of hepatobiliary system is safe, and its prevention and treatment can be done through the analysis of the causes.