对大肠癌的选择性动脉灌注化疗和栓塞治疗的临床价值进行探讨。方法：对20例大肠癌病人行选择性血管造影及超选择性插管化疗和明胶海绵栓塞；原发性大肠癌14例于介入治疗后1周内手术；复发性大肠癌6例，行一次导管治疗2例，二次2例，三次2例。结果：14例化疗栓塞后根治性切除12例，术中出血明显减少，姑息性化疗组临床症状明显改善。结论：大肠癌超选择性动脉灌注化疗和栓塞可改善临床症状，提高手术切除率，是治疗大肠癌的有效方法之一。

　　［中图分类号］　R815，R735.3+4　　［文献标识码］　A

　　［文章编号］1002-1671(2000)06-0360-03

Superselective Arterial Infusion Chemotherapy and Embolization for Colorectal Carcinoma

SONG Zhong-jin,TANG Hua,WANG Hong-zhi,LIN Hua,LIU Qi-yu,XIAN YN Jian-bo

　　（Department of Radiology,Mianyang Centre Hospital,Mianyang　621000,Sichuan Province）

　　［ABSTRACT］　Objective:To evaluate the clinical value of superselective arterial infusion chemotherapy and embolization for colorectal carcinoma.Methods:Angiography,superselective chemotherapy and embolization were done in 20 patients with colorectal carcinoma,14 patients were undergone operation one week later,6 patients with recurrent colorectal carcinoma were managed by chemoembolization for 1 to 3 times.Results:The hemorrhage was obviously reduced on operation in 12 patients after interventional therapy.The clinical symptoms were improved in 6 patients treated by palliaitive chemoembolization.Conclusion:By supereselective arterial infusion chemotherapy and embolization for treating the colorectal carcinoma may improve the clinical symptoms and increase the resection rate.

　　［Key words］radiography; interventional; therapy; colorectal carcinoma

　　大肠癌经导管动脉灌注化疗的报道较多，但经导管化疗栓塞的报道尚少，笔者就大肠癌经导管化疗栓塞的相关问题进行探讨，报告如下。

　　1　资料与方法

　　1.1　临床资料：本组共20例，男13例，女7例，年龄38～76岁，平均50.3岁。经钡灌肠、纤维结肠镜检及病理学证实。其中盲肠癌2例，结肠肝曲癌1例，脾曲癌1例，直肠癌10例，直肠癌造瘘术后4例，乙状结肠癌术后复发2例。

　　1.2　方法：全部病例均采用seldinger氏法股动脉穿刺插管，选择性肠系膜上动脉造影4例，肠系膜下动脉造影16例，髂内动脉造影8例。根据造影所显示的癌变部位、范围和肿瘤供血动脉，再作超选择性插管灌注化疗药物，和/或行明胶海绵粒(1 mm×1 mm)栓塞。本组采用6F JR4导管成攀法超选择性插管16例次，同轴导管法1例，Yashiro导管3例次。插管分别于回结肠动脉2例次，升结肠动脉及左结肠动脉各1例，肠系膜下动脉3例次，直肠上动脉13例次，髂内动脉8例次。

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