恶性肿瘤合并下腔静脉(IVC)栓子行栓子活检术的临床意义

摘要

目的 评价对恶性肿瘤合并下腔静脉(inferior vena cava,IVC)栓子患者行栓子活检术的临床意义.方法 对14例恶性肿瘤合并IVC栓子患者经右侧股静脉行IVC栓子活检.记录取出标本的成功率和患者术中及术后的不良反应或并发症,并随访2个月了解是否引起医源性肺部转移.分析病理结果,与术前CT或MRI诊断进行比较,判断影像诊断的准确率.结果 IVC栓子活检术成功率为100％,患者术中及术后未出现急性肺栓塞(pulmonary embolism,PE)及IVC破裂出血,随访2个月未发现医源性肺转移.术前影像学诊断与病理结果的符合率较高,达93％.结论 恶性肿瘤合并IVC栓子行栓子活检术是安全、微创、易行的,能为进一步治疗提供病理学依据.%Objective To evaluate the clinical significance of biopsy procedure for inferior vena cava (IVC) embolus in malignant tumor. Methods The IVC embolus biopsy procedure was performed in 14 cases of malignant tumor through right femoral vein. The success rate of biopsy,adverse reactions and complications were obtained. The iatrogenic pulmonary metastasis rate was observed through a 2 monthes follow-up program. The pathological results were compared with CT and MRI diagnosis preoperatively to verify the imaging diagnostic accuracy. Results The success rate of biopsy was 100%. No adverse reactions and severe complications such as pulmonary embolism (PE) and hemorrhage because of IVC rupture occurred. No iatrogenic pulmonary metastasis was observed during 2 monthes follow-up. The accordance rate between imaging diagnosis and pathlogical results was high (about 93%). Conclusions The embolus biopsy in IVC is safe,minimally invasive and convenient. It could provide some pathological evidence for the further therapy in malignant tumor.