目的

探讨肝癌合并肝动脉-门静脉瘘的DSA 表现和介入治疗的临床疗效。

方法

收集68例肝癌合并肝动脉-门静脉瘘的患者， 其中38例为周围型肝动脉-门静脉瘘， 30例为中央型肝动脉-门静脉瘘， 周围型肝动脉-门静脉瘘首先用明胶海绵颗粒将小瘘口栓塞， 随后注入适量的碘油和化疗药物的混合剂栓塞肿瘤； 中央型肝动脉-门静脉瘘首先超过瘘口， 在肿瘤组织中注入适量的碘油和化疗药物的混合剂， 再用明胶海绵和（或）弹簧圈将瘘口栓塞后， 继续注入适量的碘油和化疗药物的混合剂栓塞肿瘤。

结果

68例患者均治疗成功， 术后患者的临床症状减轻。

结论

DSA 是诊断肝癌合并肝动脉-门静脉瘘的可靠依据， 不同的类型采用不同的介入治疗方法能达到最好的疗效。

Objective

To explore the DSA manifestation and interventional therapy of hepatocellular carcinoma（HCC）with arterioportal fistulas.

Methods

A total of 68 patients of HCC with arterioportal fistulas were analyzed，in which 38 cases were periphery type and 30 cases were centre type.The cases with periphery type were firstly embolized with gelfoam into the fistulas，then the tumor vessels were used a mixture of lipiodol and anticancer drugs.While，across the fistulas，the cases of centre type were injected the mixture as mentioned before into tumor tissues，followed by embolizing fistulas with gelfoam and or coil，then injected the mixture into tumor tissues.

Results

All patients were successfully treated.After operative the clinical symptoms had lessened.

Conclusions

DSA is a reliable method for HCC with arterioportal fistulas.The different intervention methods can achieve its best effect according the types of HCC with arterioportal fistulas.