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目的:探讨海藻酸钠微球(sodium alginate microball,KMG)联合碘化油(lipiodo,LP)在不能手术的原发性肝癌(primary hepatic carcinoma,PHC)患者行肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)中的临床价值。方法:选取2010-01-01-2010-12-30山东省立医院PHC患者48例(观察组)应用KMG和LP作为栓塞剂行TA-CE治疗,另外选取同期行常规TACE治疗的PHC患者50例(对照组),观察两组患者的临床疗效与毒副作用。结果:术后4周,观察组患者的肝功能受损程度均比对照组轻,其中ALT为(47.15±4.64)U/L,低于对照组的(54.67±5.35)U/L,t=7.421,P=0.0000;AST为(52.32±5.63)U/L,低于对照组的(64.21±3.44)U/L,t=12.554,P=0.0000;ALB为(30.40±3.42)g/L,高于对照组的(27.99±4.53)g/L,t=2.963,P=0.003 8。观察组AFP下降幅度为726.85±500.59,高于对照组的411.12±291.85,差异有统计学意义,t=3.833,P=0.000 2;治疗后2个月,观察组有效率(CR+PR)为54.2%(26/48),对照组为46.0%(23/50),差异有统计学意义,χ2=7.782,P=0.005。两组患者治疗后3个月生存率分别为91.7%和84.0%,差异有统计学意义,P=0.003。术后6和15个月生存率差异无统计学意义,P>0.05。两组患者毒副作用发生率分别为52.1%和52.0%,差异无统计学意义,P>0.05。结论:KMG是一种使用方便、安全有效的栓塞剂,KMG+LP在TACE中疗效肯定,值得进一步扩大样本行大组临床研究。
OBJECTIVE: To investigate the effect of transcatheter arterial chemoembolization (TAE) in patients with unresectable primary hepatic carcinoma (PHC) treated with sodium alginate microspheres (KMG) and lipiodo (LP) , TACE) in the clinical value. Methods: Selected from January 2010 to January 2010,2010-12-30 Shandong Provincial Hospital PHC patients 48 cases (observation group) using KMG and LP as embolization agent in the treatment of TA-CE, the other during the same period underwent conventional TACE treatment of PHC patients 50 Cases (control group), to observe the clinical efficacy and side effects of two groups of patients. Results: At 4 weeks after operation, the degree of hepatic impairment in the observation group was lighter than that in the control group, in which ALT was (47.15 ± 4.64) U / L, lower than that of the control group (54.67 ± 5.35) U / L, t = 7.421, P = 0.0000; AST was (52.32 ± 5.63) U / L, lower than the control group (64.21 ± 3.44) U / L, t = 12.554, P = 0.0000; ALB was (30.40 ± 3.42) g / Higher than the control group (27.99 ± 4.53) g / L, t = 2.963, P = 0.003 8. The decrease rate of AFP in the observation group was 726.85 ± 500.59, which was higher than that of the control group (411.12 ± 291.85), the difference was statistically significant (t = 3.833, P = 0.000 2). At 2 months after treatment, the effective rate 54.2% (26/48) in the control group and 46.0% (23/50) in the control group, the difference was statistically significant (χ2 = 7.782, P = 0.005). Three months after treatment, the survival rates of the two groups were 91.7% and 84.0%, respectively, with statistical significance (P = 0.003). The survival rates at 6 and 15 months after operation showed no significant difference (P> 0.05). The incidence of side effects in both groups were 52.1% and 52.0%, respectively, with no significant difference (P> 0.05). Conclusion: KMG is a convenient, safe and effective embolic agent. KMG + LP has a positive curative effect in TACE and is worth further expanding in large sample clinical trials.