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目的 分析肝癌介入治疗 (TACE)几个因素与死亡时间的关系。方法 随机选择经过TACE治疗 ,在不同时间内死亡者 195例。将患者的年龄、性别、灌注的化疗药物和碘油的剂量、术前肿瘤的大小、形态、转移、门静脉癌栓、术后复发、肝功能和AFP共分为 15项变量 ,统计学采用Cox回归分析和Cox逐步回归分析方法。结果 治疗后 6个月和 12个月死亡率为 49.7%和 75 .9%。死亡时间与门静脉癌栓、弥漫型肿瘤和多发性肿瘤有明显相关 (P <0 .0 5 ,P <0 .0 0 0 1) ;肿瘤形态中弥漫型与多发性、单结节和巨块型间相差显著 (P <0 .0 5 ,P <0 .0 0 1,P <0 0 0 1) ,死亡时间与其他各组在统计学上无明显相关性 (P >0 .0 5 )。患者死于肝昏迷为 2 7.2 % ,消化道大出血为 36 .9% ,肝功能衰竭为2 3 .1% ,全身衰竭为 5 .1% ,其他为 7.2 %。结论 对部分肝功能不良的患者 ,TACE有加重肝功能损害和加速患者死亡的作用。对于肝癌患者 ,特别是有门静脉癌栓、多发性和弥漫型患者 ,治疗时应首先考虑全身和肝功能情况、肝脏对药物的耐受性 ,严格掌握时机、方法和剂量 ,术后保肝十分重要。
Objective To analyze the relationship between several factors of liver cancer interventional therapy (TACE) and the time of death. Methods TACE was randomly selected and 195 patients died within different time. The patient’s age, gender, infusion of chemotherapy drugs and lipiodol dose, preoperative tumor size, morphology, metastasis, portal vein tumor embolus, postoperative recurrence, liver function and AFP were divided into 15 variables, using Cox statistics. Regression analysis and Cox stepwise regression analysis method. Results The mortality rates at 6 and 12 months after treatment were 49.7% and 75.9%. The time of death was significantly associated with portal vein tumor thrombi, diffuse tumors, and multiple tumors (P < 0.05, P <0.01); diffuse and multiple, single nodule, and large blocks in tumor morphology. There was a significant difference between the two types (P <0.05, P <0.01, P <0.01). There was no statistically significant correlation between the time of death and other groups (P > 0.05). . The patient died of hepatic coma at 27.2%, gastrointestinal bleeding at 36.9%, liver failure at 23.1%, systemic failure at 5.1%, and others at 7.2%. Conclusions In some patients with poor liver function, TACE has aggravating liver damage and accelerating death. For patients with liver cancer, especially those with portal vein tumor thrombi, multiple and diffuse types, the systemic and liver function conditions, tolerance of the liver to drugs should be considered first, and the timing, methods, and dosage should be strictly controlled. important.