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目的 :研究肝母细胞瘤肝动脉栓塞化疗前后血流动力学改变及血流动力学变化对栓塞化疗效果的影响。方法 :运用彩色多普勒 B超监测 4例巨大肝母细胞瘤患儿在介入治疗前、介入治疗后 1周、2周、3周、4周时肝脏及瘤体的血流动力学变化和肿瘤大小改变。结果 :介入治疗前肝母细胞瘤全肝供血增加。介入治疗后近期 ,表现为肝固有动脉血流量骤减和门静脉血流量代偿性增加。随着介入治疗后时间的延长 ,肝固有动脉血流量进一步降低 ,而门静脉血流量则逐渐恢复到治疗前水平 ,肝脏和肿瘤的血供均明显减少 ,这一变化与肿瘤的缩小呈正比例。当介入治疗后时间超过 3周时 ,肝脏和肿瘤的血供又有不同程度增加 ,提示再次介入治疗的必要。结论 :彩色多普勒超声能准确反映肝母细胞瘤动脉栓塞化疗前后的血供变化 ;肝母细胞瘤介入治疗前后血流动力学改变的监测对判断介入治疗的预后以及选择再次介入治疗或手术治疗的时机具有重要的临床意义
Objective: To study the effects of hemodynamic changes and hemodynamic changes in patients with hepatoblastoma before and after transcatheter arterial chemoembolization. Methods: The color Doppler ultrasound was used to monitor the hemodynamic changes of liver and tumor in 4 patients with giant hepatoblastoma before interventional therapy, 1 week, 2 weeks, 3 weeks and 4 weeks after interventional therapy Tumor size changed. Results: Hepoblastoma increased whole liver blood supply before interventional therapy. Recent interventional therapy, the performance of the intrinsic hepatic artery blood flow and portal vein blood flow compensatory increase. With the extension of time after interventional therapy, hepatic intrinsic arterial blood flow decreased further, while portal vein blood flow gradually recovered to the pre-treatment level. Blood supply to the liver and tumor decreased significantly, which was directly proportional to tumor shrinkage. When interventional treatment more than 3 weeks, the blood supply to the liver and tumor have increased to varying degrees, suggesting the need for intervention again. CONCLUSIONS: Color Doppler ultrasound can accurately reflect the blood supply of hepatoblastoma before and after arterial embolization. The monitoring of hemodynamic changes before and after interventional treatment of hepatoblastoma can be used to evaluate the prognosis of interventional therapy and the choice of intervention or surgery The timing of treatment has important clinical implications