目的 提高对肝癌膈下动脉经动脉导管化疗栓塞术(TACE)并发脊髓损伤的认识。方法 回顾分析1例肝癌膈下动脉TACE并发脊髓损伤患者的临床资料,结合相关文献报道,探讨其可能的发病机制、危险因素、治疗和康复预后情况。结果 膈下动脉同脊髓供血动脉之间的交通支开放是TACE导致脊髓损伤的解剖学基础,而造影剂、化疗药、栓塞剂和治疗介入次数均可成为脊髓损伤的致病因素。这种脊髓损伤多是一过性的,绝大部分患者经过早期康复治疗均可在发病数周至数月内得到良好的功能恢复。结论 肝癌行经膈下动脉TACE并发脊髓损伤非常少见,在早期发现和得到及时的康复治疗后,功能预后较好。
Objective To further explore the complication of spinal cord injury occured after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma via inferior phrenic artery. MethodsThe clinical and imaging data of one patient with spinal cord injury caused by TACE for hepatocellular carcinoma via inferior phrenic artery was retrospectively analyzed. The pathologic mechanism, risk factors and outcome of rehabilitative treatment were discussed after literature review. ResultsThe abnormal opening of communicating branches between inferior phrenic artery and spinal cord blood supplying was the underlying mechanism inducing spinal cord injury after TACE. The risk factors included contrast agent, chemotherapy drug, embolic agent, and multiple interventional therapy, etc. Most patients returned almost to normal state within several months after early rehabilitation. ConclusionSpinal cord injury occurred after TACE for hepatocellular carcinoma via inferior phrenic artery is an extremely rare complication. Most patients have a favorable outcome with early detection and timely rehabilitation.
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