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.
LIU Hong-wei
,
LI Jun
,
DU Liang-jie
. Rehabilitation of Spinal Cord Injury Occured after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma via Inferior Phrenic Artery: A Case Report[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018
, 24(4)
: 472
-476
.
DOI: 10.3969/j.issn.1006-9771.2017.00.002
[1] Cheng S, Chen M, Cai J, et al.Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition[J]. Oncotarget, 2017, 8(5): 8867-8876.
[2] 张帆. 经膈下动脉介入治疗原发性肝癌的安全性[J]. 中国介入影像与治疗学, 2006, 3(6): 472-474.
[3] 李建军,周红俊. 脊髓损伤神经学分类国际标准参考手册[M]. 北京:人民卫生出版社, 2008: 67-69.
[4] 叶超群,孙天胜,李建军,等. 脊髓独立性评定及其第3版介绍[J]. 中国康复理论与实践, 2007, 13(10): 921-923.
[5] 李奎成,唐丹,刘晓艳,等. 国内Barthel指数和改良Barthel指数应用的回顾性研究[J]. 中国康复医学杂志, 2009, 24(8): 737-740.
[6] 许飞,李忱瑞,周纯武,等. 恶性肿瘤经动脉介入治疗致脊髓损伤的临床研究[J]. 医学影像学杂志, 2012, 22(2): 197-199.
[7] 周波,颜志平,吴安乐. 肝癌动脉化疗栓塞致截瘫病例分析[J]. 介入放射学杂志, 2006, 15(12): 725-727.
[8] Bazine A, Fetohi M, Berri MA, et al.Spinal cord ischemia secondary to transcatheter arterial chemoembolization for hepatocellular carcinoma[J]. Case Rep Gastroenterol, 2014, 8(3): 264-269.
[9] 王茂强,刘凤永,关俊,等. 膈下动脉参与肝肿瘤供血栓塞后并发症及其预防[J]. 介入放射学杂志, 2004, 13(1): 38-42.
[10] Kirshblum S, Campagnolo DI.脊髓医学[M]. 2版. 周谋望,陈仲强,刘楠,等,译. 济南:山东科学技术出版社, 2015: 24, 681-682.
[11] 胥少汀,郭世绂. 脊髓损伤基础与临床[M]. 3版. 北京:人民卫生出版社, 2012: 60-67.
[12] Alblas CL, Bouvy WH, Lycklama À, et al.Acute spinal-cord ischemia: evolution of MRI findings[J]. J Clin Neurol, 2012, 8(3): 218-223.
[13] Grassner L, Klausner F, Wagner M, et al.Acute and chronic evolution of MRI findings in a case of posterior spinal cord ischemia[J]. Spinal Cord, 2014, 52: S23-S24.
[14] 陈建业,陈义雄,李涛,等. 介入灌注药物致脊髓损伤5例[J]. 广东医学院学报, 2004, 22(1): 46-47.
[15] 贺继刚,岑人经,袁华. 支气管动脉介入治疗中脊髓损伤病例分析[J]. 暨南大学学报(自然科学版), 2000, 21(1): 109-111.
[16] 程云,浦丽丹,蔡晴,等. 1例肝癌化疗栓塞术后并发脊髓损伤的护理[J]. 实用临床医药杂志, 2014, 18(8): 124-125.
[17] 姜桂生. 肺癌支气管动脉灌注化疗加栓塞并发脊髓损伤8例报告[J]. 四川医学, 2001, 22(9): 827-828.
[18] 蔡守旺,冯玉泉,刘永雄. 肝癌患者肝动脉化疗栓塞致截瘫一例[J]. 中华医学杂志, 1995, 75(2): 81.
[19] 王铁云,边琪秀. 肝癌经动脉灌注化疗栓塞致脊髓损伤(附3例报告)[J]. 介入放射学杂志, 2006, 15(6): 372-373.
[20] 杨熙章,杨利,陈自谦,等. 支气管动脉化疗栓塞术导致脊髓损伤的原因与对策[J]. 中国介入影像与治疗学, 2008, 5(6): 429-432.
