小剂量肝素联合奥曲肽对原发性肝癌TACE术后肝外转移的影响  

Clinical observation of transcatheter hepatic arterial chemoembolization combined with low-dose heparin and octreotid on extrahepatic metastasis of primary hepatocellular carcinoma

作　　者：樊高飞[1] 荚卫东[2] 范平生[1] 张腾跃[1] 杨守梅[1] 冯克海[1] 魏强[1] 钱立庭[1] 

机构地区：[1]安徽省肿瘤医院肿瘤科,合肥230031 [2]安徽省立医院普外科,230031

出　　处：《临床肿瘤学杂志》2011年第4期330-334,共5页Chinese Clinical Oncology

摘　　要：目的观察小剂量肝素联合奥曲肽对原发性肝癌TACE术后肝外转移的影响。方法共入组147例原发性肝癌患者,分为对照组63例和治疗组84例,均行TACE治疗。治疗组术前2天予静脉输注小剂量肝素（1250~2500U）,每天1次,共10~14天;术前给于奥曲肽0.1mg皮下注射,行TACE术同时予奥曲肽25μg/h静脉滴注72h。TACE每月治疗1次,2~4次后评价疗效及毒副反应。结果两组患者肿瘤原发病灶变化无统计学意义;对照组3、6、9、12个月转移率分别为4.7%、12.7%、12.7%和25.4%,治疗组分别为1.1%、3.5%、3.5%和4.8%,两组差异有统计学意义（P〈0.05）。对照组术后6、9、12个月AFP水平上升率分别为7.9%、19.0%和31.7%,治疗组分别为6.0%、9.5%和11.9%,两组差异有统计学意义（P〈0.05）。两组患者KPS评分、毒副反应及凝血功能均无显著性差异。结论小剂量肝素联合奥曲肽可能降低原发性肝癌TACE术后肝外转移的发生率,且不增加毒副反应,对肿瘤原发病灶及凝血功能无明显影响。Objective To evaluate the effect of transcatheter hepatic arterial chemoembolization（TACE） combined with low-dose heparin and octreotid on extrahepatic metastasis of primary hepatocellular carcinoma.Methods Both the control group and treatment group were treated by TACE.In addition,treatment group was treated by low-dose heparin（1250-2500U intervenous infusion,once a day for 10-14 days pre-operation） and SMS 201-995 octreotide（0.1mg hypodermic injection 30min pre-operation and intervenous infusion 72h with the speed of 25μg/h）.The two groups underwent TACE once a month,and efficacy,quality of life and side effects were evaluated after 2-4 times treatment.Results There was no statistical significant of variation of primary lesion between the two group（P0.05）.The incidence of tumor metastasis 3,6,9,12 months after TACE in control group was 4.7%,12.7%,12.7% and 25.4% compared with 1.1%,3.5%,3.5% and 4.8% in treatment group with statistic significance（P0.05）.The arise of AFP level 6,9,12 month after TACE in control group was 7.9%,19.0% and 31.7% compared with 6.0%,9.5% and 11.9% in treatment group with statistic significance（P0.05）.Quality of life,side effect and blood coagulation did not show difference between the two groups.Conclusion The incidence of tumor metastasis can be depressed by the combination of low-dose heparin and octreotide after TACE of primary hepatocellular carcinoma,and won＇t increase the side effect and influence on primary lesion and blood coagulation.

关 键 词：原发性肝癌 经导管肝动脉化疗栓塞 肝素 奥曲肽 转移 

分 类 号：R735.7[医药卫生—肿瘤]