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介入治疗在小儿腹部恶性肿瘤的应用 |
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刘钧澄 李桂生 庄文权 莫家骢 刘唐彬
【摘要】 目的 对巨大腹部肿瘤采用介入治疗，为肿瘤完整切除创造有利条件。方法 对12例腹部恶性肿瘤患儿进行介入治疗,其中男7例，女5例。年龄2个月～7岁。肝母细胞瘤6例，神经母细胞瘤3例，肾母细胞瘤2例，肾上腺皮质癌1 例。采用Seldinger’s技术进行动脉插管造影，确定肿瘤主要供血动脉，进行肿瘤供血动脉超选择性插管，局部注入化疗药物，然后用碘油、明胶海绵或白芨微球栓塞肿瘤的供血动脉。结果 12例中7例手术切除了肿瘤，1例剖腹探查。余下4例通过介入治疗后，肿瘤明显缩小。12例患儿随访追踪，至今存活10例。结论 介入治疗既可经肿瘤供养动脉注入化疗药物，肿瘤局部化疗药物浓度高，减少全身副作用，又可阻断肿瘤供养动脉，使肿瘤缺血坏死，达到治疗目的。同时栓塞后，肿瘤包膜增厚，有利于手术中完整切除肿瘤。
【关键词】 腹部肿瘤 癌 放射学，介入性 儿童
Interventional Therapy for Abdominal Malignant Tumors in Children
LIU Juncheng, LI Guisheng, ZHUANG Wenquan， et al.
Department of Pe diatric Surgery, The First Affiliated Hospital of Sun Yat-sen University of Med ical Sciences, Guangzhou 510080
【Abstract】 Objective The study aims to evaluate the feasibility of preoperative interventional therap y in pediatric abdominal malignant tumors. Methods Twelve children, 7 boys and 5 girls(age range=2 months to 7 years) underwent chemo-embolization. There were 6 hepatoblastomas, 3 neuroblastomas, 2 Wilms’ tumors and one malignant adrenal cortex tumor. Major arteries supplying the tumors were determined by arteriogram(Seldinger’s techn ique). The arteries were selectively cannulated and embolized with cytotoxic che motherapeutic agents, iodized oil and gelfoam. Results Of them,the tumors of 7 cases were rendered resec table and 4 cases shank in size. One patient underwent explorative laparotomy. T en cases have survived. Conclusions Interventional therapy via the main tumor art eries enables administration of higher concentration of cytotoxic agents with mi nimal systemic side-effects. It also leads to ischemic tumor necrosis. The thic kening of the tumor capsule facilitates the subsequent complete removal.
【Key words】 Abdominal neoplasms Carcinoma Radiology, interventional Child
大多数腹部恶性肿瘤患儿就诊时已属晚期，肿瘤已较大，与周围血管粘连甚紧，手术难以完整切除，需先行化疗等辅助疗法，待其缩小再施行延期手术［1，2］。我院对12例巨大腹部恶性肿瘤患儿施行手术前介入治疗，现报道如下。
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