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目的回顾性研究经肝动脉超选择性化疗栓塞术(TACE)联合经皮无水酒精消融(PEI)双介入治疗中、晚期肝癌的临床价值。方法随机选择我院近3年经过介入治疗的45例中、晚期肝癌患者,其中22例行TACE联合PEI治疗,23例行单纯TACE治疗,比较两种方法治疗后肿瘤的大小、AFP变化及6个月、1年、2年生存率。结果TACE+PEI双介入治疗组22例肝肿瘤中有19例(86.4%)体积缩小,其中7例(36.8%)肿瘤缩小>50%,12例(63.2%)缩小<50%。单纯TACE组23例肝肿瘤中有11例(47.8%)体积缩小,其中4例(36.4%)肿瘤缩小>50%,7例(63.6%)体积缩小<50%,两组肿瘤缩小变化差异有统计学意义(χ2=7.51,P<0.05)。TACE+PEI组有6例(27.3%)AFP恢复正常,13例(59.1%)AFP显著下降。单纯TACE组有3例(13.1%)AFP恢复正常,11例(47.8%)AFP明显下降,两组AFP变化差异有统计学意义(χ2=18.89,P<0.01)。TACE+PEI组6个月、1年、2年生存率分别为86.4%、63.6%、45.5%,单纯TACE组6个月、1年、2年生存率分别为65.2%、39.1%、13.1%,两组生存率差异有统计学意义(χ2=7.69,P<0.05)。结论TACE联合PEI双介入治疗中、晚期肝癌优于单纯TACE,是一种安全有效的综合治疗方法。
Objective To retrospectively study the clinical value of transarterial superselective chemoembolization (TACE) combined with percutaneous ethanol ablation (PEI) double interventional therapy for advanced and advanced liver cancer. Methods Totally 45 patients with advanced hepatocellular carcinoma who underwent interventional therapy in our hospital for the last 3 years were randomly selected. TACE combined with PEI was performed in 22 of 22 patients. TACE alone was performed in 23 patients. Tumor size, AFP, Month, 1 year, 2 year survival rate. Results Twenty-two of 22 (86.4%) TCC + PEI-treated groups showed a decrease in size, of which 7 (36.8%) had a 50% reduction in size and 50% reduction in 12 patients (63.2%). Eleven patients (47.8%) in 23 TCC pure tumors showed a decrease in size, of which 4 (36.4%) had a tumor shrinkage of> 50% and 7 (63.6%) had a volume reduction of <50% Statistical significance (χ2 = 7.51, P <0.05). Six cases (27.3%) of AFP returned to normal in TACE + PEI group and 13 cases (59.1%) of AFP decreased significantly. AFP in 3 cases (13.1%) in TACE group returned to normal, while AFP in 11 cases (47.8%) decreased significantly. The difference of AFP between the two groups was statistically significant (χ2 = 18.89, P <0.01). The 6-month, 1-year and 2-year survival rates of TACE + PEI group were 86.4%, 63.6%, 45.5% respectively. The 6 months, 1 year and 2 year survival rates of TACE alone group were 65.2%, 39.1%, 13.1% There was significant difference between the two groups (χ2 = 7.69, P <0.05). Conclusions TACE combined with PEI double intervention is superior to simple TACE in middle and advanced liver cancer, which is a safe and effective comprehensive treatment.