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目的 对比生物微球与明胶海绵用于原发性肝癌伴脾功能亢进双介入治疗中的临床疗效.方法 分析我院122例原发性肝癌伴脾亢患者行肝动脉化疗栓塞术+脾动脉栓塞术双介入治疗的临床资料,按照所用栓塞剂不同分为实验组(n=62)(肝癌栓塞:碘化油+微球,脾栓塞:微球),对照组(n=60)(肝癌栓塞:碘化油+明胶海绵,脾栓塞:明胶海绵).比较两组术后一月上腹部CT平扫+增强和肝脏彩超检查、肝功能及AFP值.术前与术后第3、7、30天分别外周血白细胞、血小板变化及并发症的情况.结果 术后实验组肿瘤治疗有效率明显高于对照组;第3、7、30天WBC、PLT较对照组明显升高,差异有统计学意义(P<001).术后两组肝功能及并发症差异无统计学意义.结论 与明胶海绵比较,生物微球用于原发性肝癌合并脾功能亢进双介入治疗中的临床效果显著,安全可靠,能较好的控制病情发展,改善病人血象,并发症少,提高病人生存期和生活质量.
Objective To compare the clinical efficacy of biological microspheres and gelatin sponge for double interventional therapy of primary hepatocellular carcinoma with hypersplenism.Methods 122 cases of primary liver cancer with hypersplenism in our hospital underwent hepatic artery chemoembolization plus splenic artery embolization According to the different embolic agents used, the clinical data were divided into experimental group (n = 62) (liver cancer embolization: iodized oil + microspheres, splenic embolism: microspheres), control group (n = 60) : Iodized oil + gelatin sponge, splenic embolization: gelatin sponge) .Two months after operation, CT scan and contrast enhancement, hepatic function and AFP value of the upper abdomen were compared between preoperative and postoperative 3,7, 30 days of peripheral blood leukocytes, platelet changes and complications.Results The effective rate of tumor treatment in experimental group was significantly higher than that in control group on the 3rd, 7th and 30th days, the WBC and PLT levels were significantly higher than the control group (P <001) .After operation, there was no significant difference in liver function and complications between the two groups.Conclusion Compared with gelatin sponge, the clinical effect of bio-microspheres for double interventional therapy of primary hepatocellular carcinoma with hypersplenism is significant , Safe and reliable, can better control the progression of the disease, improve the patient’s blood, and Less disease, improve patient survival and quality of life.