| Isolated hepatic perfusion (IHP) is a means for treatment of liver cancer. This method is paid attention to following the development of interventional radiology. The aim is to ensure high concentration of chemotherapeutic agents in the liver, while avoid the durgs entering the systemic circulation. However, many problems remain to be solved up to now, these problems include: 1) The procedure is complex and the clinical application can not be used widely. 2) All the procedure is whole liver isolation and perfusion, which is not helpful for the protection of normal liver. 3) IHP does not combine with the other effective methods for the treatment of liver cancer.For faults of IHP, following researches were studied: 1) To establish the method of percutaneous regional isolated hepatic perfusion (PRIHP) by animal experiment for simplifying the procedure. 2) To investigate the effect of increaseing concentration of chemotherapeutic agents in regional liver and decreasing concentration in system using the method of percutaneous regional isolated hepatic perfusion-charcoal hemoperfusion (PRIHP-CHP) by pharma-cokinetics analysis. 3) To analyze the feasibility for the treatment of liver cancer by combining PRIHP-CHP with transcatheter arterial chemo-embolization under temporary hepatic venous occlusion (TACE-THVO).The results of our studies showed:1. All the procedures were successful in the experiment of PRIHP-CHP in eight dogs, but 1 dog died because of air embolization. There were no other complications in the experiment. The average procedure duration for each wasin132.3 ?5.3 minutes.2. Using the method of high performance liquid chromatography (HPLC), plasma adriamycin concentration of hepatic venous blood and systemic venous blood in transcatheter arterial infusion (TAI) and hepatic venous blood (per-hemoperfusion), post-hemoperfusion, systemic venous blood in PRIHP-CHP were detected, the data were analyzed by pharmacokinetic method. The peak level of adriamycin concentartion in hepatic vein and systemic in TAI were 3709.676?85.723ng/ml and 1576.140 ?26.933ng/ml, respectively, the area under the curve (AUC) were 22374.40 ?308.77ng/ml/min, 9242.10 + 249.99ng/ml/min, respectively. In PRIHP-CHP, the peak level of adriamycin concentration in hepatic vein and systemic were 4653.420 +430.204ng/ml and 433.612?0.501ng/ml, AUC were 32572.49 + 1220.65ng/ml/min and 3158.26 ?05.61ng/ml/min. There were statistically significant differences between TAI and PRIHP-CHP (P<0.01). The average clearance proportion of adriamycin by charcoal hemoperfusion was 69.4 ?.2%.3. All the procedures of PRIHP-CHP combined with TACE-THVO were successful by the interventional technology, no complications were found. Blood routine examination showed the decreasing of leukocytes and thrombocytes were lighter in PRIHP-CHP and PRIHP-CHP combined with TACE-THVO than in TAI. Liver function examination showed temporary rising of ALT, AST, ALP in PRIHP-CHP and PRIHP-CHP combined with TACE-THVO. Pathological examination showed hepatic sinusoid dilatation and hepatic cell hydropic degeneration, no hepatic necrosis was found.On the basis of the above, we draw the following conclusions: 1. PRIHP-CHP is a feasible method which has many advantages such as: 1) simplifying the procedure and easy to clinical application, 2) the trauma to the patients and the complication is slight, 3) normal liver can be protected because of regional liver therapy, 4) easy for retreatment.2. In the condition of PRIHP, adriamycin in the hepatic vein can be effectively cleared by charcoal hemoperfusion.3. Using the technology of PRIHP-CHP, the concentration of chemo-therapeutic agents can increase in regional liver, and even more markedly decrease in systemic circulation. According to the theory of pharmacockinetics, it can be proved that PRIHP-CHP is an effective method to treat liver cancer.4. The effect of ar...
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