关键词: 肝血管瘤, 肝动脉栓塞介入术, 瘤体缩小率, 肝功能, 并发症

Abstract: Objective To investigate the relationship between the type of blood supply and the efficacy of transcatheter arterial interventional therapy for hepatic hemangioma.Methods 128 patients with hepatic hemangioma admitted to our hospital from January 2017 to January 2019 were divided into three groups according to their blood supply. They were rich blood supply group (case number = 43), medium blood supply group (case number = 47), and deficient blood supply group (case number = 38).All patients underwent interventional therapy via hepatic artery embolization. The clinical effects of three groups were evaluated at 3 and 6 months after operation, and the reduction rates of tumors and arterial phase enhancement were recorded at 6 months after operation.The liver function indexes, including alanine aminotransferase (AAT), direct bilirubin (DB) and total bilirubin (TB), were compared before and 3, 7 and 14 days after operation in three groups, and the complications were analyzed.Results The total remission rates of the rich blood supply group and the medium blood supply group were [76.74% and 72.34%] respectively, which were significantly higher than those of the hypovascular group [47.37% (P<0.05)].The total remission rates of the blood supply group and the medium blood supply group were [72.09% and 63.83%] respectively, which were significantly higher than those of the hypovascular group [(39.47% (P<0.05)].The tumor shrinkage rates of the rich blood supply group and the medium blood supply group were [(55.62±10.05)%, (50.34±8.51)%], which were significantly higher than those of the poor blood supply group [(31.28±8.32)% (P<0.05)].The reduction rates of arterial phase enhancement in the rich blood supply group and the medium blood supply group were [(28.53±5.12)%, (23.64±4.87)%], which were significantly higher than those in the poor blood supply group [(17.29±5.23)% (P<0.05)].The serum levels of AAT, DBil and TBil at 3 and 7 days after operation in the three groups were higher than those before operation (P<0.05).The incidence of fever, nausea, vomiting, cholecystitis and upper abdominal pain in the rich blood supply group was [9.30%, 6.98%, 2.33%, 0.00% and 4.65%], respectively. There was no significant difference in complication rate among the three groups (P>0.05).Conclusion Compared with the patients without blood supply, the patients with rich blood supply and medium blood supply had better curative effect 3 or 6 months after transcatheter arterial embolization, and the reduction rate of tumor size and arterial phase enhancement was higher than that of the patients without blood supply. However, there was no significant difference in liver function and complications among the patients with different blood supply types.

Key words: Hepatic hemangioma, Transcatheter arterial interventional therapy, Tumor reduction rate, Liver function, Complication