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目的观察中晚期肝癌患者经动脉导管介入治疗的近期疗效。方法选择2011年10月—2013年10月宁波市第二医院收治的53例原发性中晚期肝癌患者为研究对象,根据肿瘤大小分为小肝癌组(直径≤5 cm)和大肝癌组(直径>5 cm)。所有患者均给予经动脉导管介入治疗,选择经皮股动脉穿刺,超声引导下将插管插到肝固有动脉或肝左右动脉,注入顺铂+丝裂霉素+5-氟尿嘧啶,间隔1个月再行灌注,方法同前,以此重复3~4次。评估介入前后症状改善情况、疗效评价、卡氏评分及生存率。结果治疗后,53例中晚期肝癌中,食欲改善者30例,腹痛减轻者28例,体重增加者23例,且小肝癌组以上人数多于大肝癌组(P<0.05);AFP降低者共23例,其中小肝癌组AFP降低者比例高于大肝癌组(P<0.05);治疗后,53例中晚期肝癌中,CR+PR为36例,达67.9%,其中小肝癌组有效率(83.3%)高于大肝癌组有效率(55.2%),P<0.05;与治疗前相比,53例患者ALT、AST均较治疗前提高(P<0.05),治疗后,大肝癌组ALT、AST、TBIL均高于小肝癌组(P<0.05);53例患者1、2、3年生存率分别为60.4%、47.2%、24.5%,小肝癌组1、2年生存率高于大肝癌组(P<0.05),2组3年生存率差异无统计学意义,小肝癌组治疗后卡氏评分高于大肝癌组(P<0.05)。结论经动脉导管介入治疗中晚期肝癌可有效改善患者近期疗效,提高患者半年生存率,且其对近期疗效的影响与肿瘤大小有关。
Objective To observe the short term efficacy of transcatheter arterial catheterization in patients with advanced liver cancer. Methods From January 2011 to October 2013, 53 patients with primary hepatocellular carcinoma (HCC) admitted to the Second Hospital of Ningbo were enrolled. According to the size of the tumor, they were divided into small hepatocellular carcinoma (diameter ≤5 cm) and large hepatocellular carcinoma Diameter> 5 cm). All patients were given transcatheter arterial catheterization, the choice of percutaneous femoral artery puncture, ultrasound-guided intubation into the hepatic artery or left hepatic artery, into the cisplatin + mitomycin + 5-fluorouracil, an interval of 1 month Repeat perfusion, the same method as before, repeated 3 to 4 times. Assessment of symptoms before and after intervention to improve the situation, efficacy evaluation, card score and survival rate. Results After treatment, there were 30 cases of appetite improvement, 28 cases of reduced abdominal pain, 23 cases of weight gain, and the number of patients with small hepatocellular carcinoma was higher than that of large hepatocellular carcinoma (P <0.05) Among 23 cases, the proportion of AFP decreased in small hepatocellular carcinoma group was higher than that in large hepatocellular carcinoma group (P <0.05). After treatment, CR + PR in 53 cases of advanced hepatocellular carcinoma was 36 cases (67.9%), 83.3%) were higher than that of the large hepatocellular carcinoma (55.2%), P <0.05; Compared with before treatment, the ALT and AST of 53 patients were significantly higher than those before treatment (P <0.05) (P <0.05). The 1, 2, 3-year survival rates of 53 patients were 60.4%, 47.2% and 24.5%, respectively. The 1-year and 2-year survival rates of small hepatocellular carcinoma were significantly higher than those of large hepatocellular carcinoma Group (P <0.05). There was no significant difference in 3-year survival rate between the two groups (P <0.05). The Karnofsky score of small hepatocellular carcinoma group was higher than that of the large hepatocarcinoma group (P <0.05). Conclusions Transcatheter arterial catheterization in the treatment of advanced hepatocellular carcinoma can effectively improve the short-term effect and improve the half-year survival rate of patients, and its effect on the short-term efficacy is related to tumor size.