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目的探讨经肝动脉化疗栓塞术联合射频消融术治疗原发性肝癌的临床疗效。方法选取临汾市人民医院2013年收治的原发性肝癌患者65例,随机分为对照组32例和观察组33例。对照组患者行肝动脉化疗栓塞术治疗,观察组患者在对照组基础上加用射频消融术治疗。随访3年,比较两组患者的临床疗效,治疗前、后卡氏评分及甲胎蛋白(AFP)水平,术后1、2、3年无瘤生存情况及肿瘤坏死程度。结果观察组患者治疗缓解率高于对照组(P<0.05)。治疗前,两组患者卡氏评分、AFP水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者卡氏评分高于对照组,AFP水平低于对照组(P<0.05)。随访3年,观察组患者1年、2年、3年无瘤生存率高于对照组(P<0.05)。观察组患者肿瘤坏死程度优于对照组(P<0.05)。结论经肝动脉化疗栓塞术联合射频消融术治疗原发性肝癌临床疗效明显,可有效降低AFP水平,提高无瘤生存率,改善肿瘤坏死程度。
Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of primary liver cancer. Methods Sixty-five patients with primary liver cancer admitted to Linfen People’s Hospital in 2013 were randomly divided into control group (32 cases) and observation group (33 cases). Patients in the control group underwent transcatheter arterial chemoembolization. The patients in the observation group were treated with radiofrequency ablation on the basis of the control group. The patients were followed up for 3 years. The clinical curative effect, the Karnofsky score, the AFP level before and after treatment, the tumor-free survival and the degree of tumor necrosis at 1, 2 and 3 years after operation were compared. Results The response rate of observation group was higher than that of control group (P <0.05). Before treatment, the Karnofstem scores and AFP levels were not significantly different between the two groups (P> 0.05). After treatment, the Karnofstal score of the observation group was higher than that of the control group, and the AFP level was lower than that of the control group (P <0.05) . After 3 years of follow-up, the 1-year, 2-year and 3-year disease-free survival rates in the observation group were significantly higher than those in the control group (P <0.05). The degree of tumor necrosis in observation group was better than that in control group (P <0.05). Conclusions The therapeutic effect of transcatheter arterial chemoembolization combined with radiofrequency ablation on primary hepatocellular carcinoma is obvious, which can effectively reduce the level of AFP, improve the tumor-free survival rate and improve the degree of tumor necrosis.