ANALYSIS THE REASONS OF PULMONARY EMBOLISM AFTER TRANSCATHERTER ARTERIAL CHEMOEMBOLIZATION IN HEPATOCELLULAR CARCINOMA

Objective To discuss the clinical characteristics,pathogenic mechanism,early diagnosis and treatment for pulmonary embolism after transcatheter arterial chemoembolization(TACE) in hepatocellular carcinoma.Methods From January 2000 to December 2007,4 cases suffered pulmonary embolism after TACE in the total of 31869 hepatocellular carcinoma patients.The clinical characteristics,pathogenic mechanism,early diagnosis and treatment of these 4 cases were retrospectively analyzed.Results The incidence of pulmonary embolism was 0.02% after TACE.Pulmonary embolism was found during 0.5 hour to 5 days after TACE.They show characteristics syndrom of pulmonary embolism,such as difficult breathe,cyanosis,cardiopalmus,thoracodynia,jaundice,hematuria and degression of oxygen partial pressure and saturation of blood oxygen.2 patients died,and the mortality was 50%.Conclusion:Pulmonary embolism is one of the serious complicants after TACE in hepatocellular carcinoma and is caused by multiple factors in which iodized oil occlusion is the chief factor.It has a flash onset and a high mortality.Pulmonary angiography and D-Dimer play an important part in the early diagnosis.