ObjectiveTo explore the clinical efficacy of transcatheter arterial embolization or transcatheter arterial embolization combined with percutaneous transhepatic sclerotherapy injection for hepatic cavernous hemangioma with different blood supply. MethodsEighty-six patients with hepatic cavernous hemangioma with different blood supply received femoral artery pingyangmycin iodized oil embolization or transcatheter arterial embolization combined with percutaneous transhepatic injection of pingyangmycin iodized oil embolization from February 2004 to April 2013. ResultsForty-five cases (52.3%) of tumor decreased by over 50%; 26 (30.2%) decreased by about 20% to 50%; 11 (12.8%) decreased by less than 20%; and 4 (4.7%) had no significant change in the tumor diameter. Patients did not have serious complications. ConclusionThe effect of individualized intervention for hepatic cavernous hemangioma with different blood supply is obvious, and it is a safe and effective therapeutic method.
目的 探讨电化学疗法(EChT)对肝海绵状血管瘤(CHL)的治疗价值。方法 应用EChT在剖腹下治疗8例CHL，17个瘤灶。1例合并结节性肝硬变，5例为多发性CHL，14个瘤灶。结果 治疗过程中肝出血量均不超过20 ml。术后无胆漏、腹腔内出血、黄疸、气体栓塞等并发症产生。治疗后随访5～7年，无1例出现瘤灶复发。结论 EChT是治疗CHL的安全而有效的新方法，适合伴有背景肝病的CHL和多发性CHL的治疗，且易于在基层医院推广。
目的总结肝尾状叶海绵状血管瘤手术切除的指征及技巧。方法对我科2005年9月至2010年9月期间开展的8例肝尾状叶海绵状血管瘤切除病例的临床资料进行分析。结果全组患者均在无血流阻断下顺利完成手术，无手术死亡。术中出血量为1 000～5 000 ml，（2 500±800） ml; 手术时间为3～6 h，(4.2±0.8） h。1例肝硬变患者术后1 d即出现腹水，经积极治疗后得以控制。3例患者术后1周发现右侧胸腔积液，经1～2次胸腔穿刺抽液后治愈。1例患者术后1周出现不全性肠梗阻，经保守治疗1周后痊愈。术后应用B超每半年复查肝脏情况，随访0.5～5年，（2.5±1.2）年，1例失访，1例患者死于心肌梗死，余均存活，仍在随访中。所有病例均未复发。结论肝尾状叶海绵状血管瘤手术应充分显露、精准操作，彻底切除肿瘤，避免大出血和空气栓塞，减少和防止残肝的热缺血再灌注损伤。
OBJECTIVE: To discuss clinical application of the color Doppler ultrasonography in diagnosis and treatment of cavernous hemangioma in deep subcutaneous tissue. METHODS: From 1996, 15 cases of cavernous hemangioma were diagnosed and located with color Doppler ultrasonography and were embolized under monitoring of the ultrasonography or resected by operation before re-examination of the hemangioma via the color Doppler ultrasonography after the intervention. RESULTS: Direct embolization was achieved in 10 cases after pinpoint location of the hemangioma by the ultrasonography, and guided embolization was performed successfully in 2 cases via the monitoring of ultrasonography, and operation had to be adopted to remove the focus. No reoccurrence of the hemangioma was observed in all the cases. CONCLUSION: Cavernous hemangioma in deep subcutaneous tissue could be easily diagnosed and located with color Doppler ultrasonography, and could be removed by embolization under monitoring of the ultrasonography successfully.