小儿肾胚胎瘤术前介入治疗16例
- 摘要:
- 目的总结小儿肾胚胎瘤介入治疗的方法与经验。方法对16例临床诊断为肾胚胎瘤的患儿于手术前经肾动脉缓慢灌注大剂量化疗药物。采用氯胺酮作静脉全身麻醉,选择合适穿刺针行股动脉穿刺,采用顺插法自股动脉插入导管至肾动脉,用高压注射器按1～1.5ml/kg,5ml/s的流速注入76%泛影葡胺。用岛津1000毫安C形臂心血管造影机作检查,通过电影摄影同时拍摄电视录相两套系统进行记录,观察其术中瘤体剥离、出血及肿块大小情况。结果16例均顺利插管,14例行1次介入治疗,2例行2次介入治疗,1周后均行CT复查,见肿瘤病灶明显缩小。术中经介入治疗的病例瘤体减小,浸润粘连减轻,出血明显减少。结论小儿肾胚胎瘤术前介入治疗能减轻瘤体大小,使肿瘤的浸润粘连减轻,提高手术成功率,介入治疗过程中选择合适的导管,插入方法以及化疗药物是治疗成功的关键。
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