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目的探讨肝动脉化疗栓塞(TACE)联合栓塞肿瘤肝外侧支动脉治疗原发性肝癌(HCC)的临床疗效。方法回顾性分析79例原发肝癌介入治疗,其中采用TACE联合栓塞肿瘤肝外侧支动脉40例(A组),只接受单纯肝动脉TACE 39例(B组),两组临床资料差异无统计学意义。对比观察两组患者近期甲胎蛋白(AFP)及肿瘤变化,随访生存时间。统计学分析采用PASWl 8.0统计软件,计量资料以“x±s”表示,手术前后数据之间的差异采用配对t检验;采用Kaplan-Meier计算中位生存期;P<0.05为差异有统计学意义。结果 A、B两组6个月时AFP下降(例)27/32对比20/33,χ~2=4.580,P=0.039。肿瘤治疗后3个月及6个月时反应(CR+PR+SD)情况为35/40对比32/39,χ~2=0.458,P=0.518;32/38对比23/37,χ~2=4.653,P=0.029。两组患者术后生存时间,A组为6~56个月,平均(24.85±11.68)个月,B组为6~48个月,平均(17.46±6.56)个月,t=3.048,P=0.004。结论TACE联合栓塞肿瘤肝外侧支动脉较单纯肝动脉TACE疗效明显优,肝外侧支动脉是影响原发性肝癌介入治疗的重要因素,采取规范、综合措施,积极预防、治疗原发性肝癌肝外侧支动脉,可提高原发性肝癌中远期疗效。
Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with hepatic artery in the treatment of primary hepatocellular carcinoma (HCC). Methods A total of 79 primary hepatocellular carcinoma (HCC) interventions were retrospectively analyzed. TACE was performed in 40 patients (group A) with embolization of the extrahepatic branch of the tumor, and only received TACE in 39 patients (group B). There was no significant difference in clinical data between the two groups significance. Compare the two groups of patients with recent AFP and tumor changes, follow-up survival time. Statistical analysis using PASWl 8.0 statistical software, measurement data to “x ± s ” said the data before and after the difference between the use of paired t test; using Kaplan-Meier median survival; P <0.05 for the difference statistics Significance of learning. Results The AFP decreased at 6 months in group A and group B (cases) 27/32 compared with 20/33, χ ~ 2 = 4.580, P = 0.039. The response (CR + PR + SD) was 35/40 vs 32/39 at 3 months and 6 months after tumor treatment, χ ~ 2 = 0.458, P = 0.518, 32/38 vs. 23/37, and χ ~ 2 = 4.653, P = 0.029. The average survival time in group A was 6 to 56 months (24.85 ± 11.68) months, in group B between 6 and 48 months (mean, 17.46 ± 6.56 months, t = 3.048, P = 0.004. Conclusions The TACE combined with hepatic artery extrahepatic branch artery is superior to TACE in simple hepatic artery. The extra-hepatic branch artery is an important factor influencing the interventional therapy of primary hepatic carcinoma. Standard and comprehensive measures are taken to prevent and treat the hepatocellular carcinoma Artery, can improve the long-term efficacy of primary liver cancer.