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小儿腹部恶性肿瘤的介入治疗

时间:2007-12-12 23:58:52  来源:  作者:

AbstractObjectiveTo investigate the significance of interventional treatment before radical resection of the abdominal neoplasm in children.Methods ALL of 13 patients with abdominal malignant tumor received interventional therapy. They were 6 cases of hepatoblastoma,4 of neuroblastoma,2 of nephroblastoma and 1 of adrenocortical carcinoma. The procedure was transarterial chemoembolotherapy.In the procedures precise arterography was performed to find out the feeding artery of the malignancy.And then superselective catheterization of those arteries was perfomed to obtanin better therapeutic results.Gelform particles and lipid iodine were applied in the embolization.ResultsThe neoplasms w ere entirely removed in 7 cases out of 13. In the other 6 patients, the tumors were unresectable.The tumors shrank after the interventional chemoembolotherapy in 5 patients.Eleven patients out of 13 survived till now in the 18 months follow-up period.ConclusionsInterventional treatment (transarterial chemoembolotherapy) will ensure the high dose chemotherapy to be given,and decrease the systemic side effects. Embolization blocks the arterial supply of tumor,which results in the ischemia and necrosis of the tumor. And the malignant neoplasms will be thickly capsulated after interventional procedures,making radical resection possible.


Key words
Malignant tumor; Abdominal;Radiology;Interventional;Children

 

 

大多数小儿腹部恶性肿瘤患儿就诊时,多已属晚期,肿瘤已较大,与周圈血管粘连甚紧,手术难以完整切除,需先行化疗等辅助疗法,待其缩小再施行择期手术〔12〕。我院对13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。


  1材料与方法


  11一般资料


  l9977月~199812月我院对13例小儿腹部巨大恶性肿瘤进行手术前介入治疗。其中男7例,女6例。年龄最小2个月最大7岁。肝母细胞瘤6例,肿瘤大小由65cm×78cm×85cm165cm×175cm×18.5cm不等,平均为92cm×101cm×128cm,无周围淋巴结肿大。肾母细胞瘤2例,大小为103cm×14cm×17cm13.5cm×l4cm×155cm,其中l例有腹主动脉旁淋巴结肿大、肿瘤波及下腔静脉。神经母细胞瘤4例,肿瘤大小由4cm×55cm×63cm73cm×8.5cm×9cm等,平均为56cm×7cm×76cm,其中1例侵犯右肾静脉,2例有腹膜后淋巴结肿大伴肺转移。肾上腺皮质癌1例,大小为5cm×5cm×6cm,肿瘤与横结肠系膜粘连。肝母细胞瘤6例中2例因肝肿瘤巨大行了两次介入治疗才手术切除,神经母细胞瘤中l例侵犯右肾静脉和l例有腹膜后淋巴结肿大者均行了两次介入治疗。

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