TACE联合外科手术治疗原发性肝癌破裂出血96例疗效分析  

Therapeutic Effect of Transcatheterhepatic Arterial Chemoembolization(TACE)Combined with Operation on 96 Cases of Primary Hepatic Carcinoma

作　　者：滕毅山[1] 王家平[2] 童玉云[2] 孔鹏[2] 杨青[2] 江华[2] 

机构地区：[1]昆明医学院第二附属医院腹部微创外科,云南昆明650031 [2]昆明医学院第二附属医院放射科介入室,云南昆明650031

出　　处：《昆明医学院学报》2011年第8期53-56,共4页Journal of Kunming Medical College

基　　金：云南科技计划资助项目(2009ZC111M);云南省教育厅科学研究基金资助项目(601090200506)

摘　　要：目的评价肝动脉化疗栓塞(TACE)联合伽玛刀治疗原发性肝癌破裂出血的临床疗效及不良反应.方法对96例肝癌患者随机分为两组:TACE+伽玛刀组(综合治疗组)48例,单纯伽玛刀治疗组(对照组)48例.比较两组治疗后的近期疗效、临床受益反应、生存期及不良反应.结果综合组、对照组有效率分别为92.3%和75.0%,综合治疗组的临床获益疗效明显较对照组高,两组1 a生存率分别为88.5%、65.3%;两组的副反应血红蛋白及血小板下降无明显差异,白细胞下降、肝功能损害、恶心、呕吐等综合治疗组发生几率明显高于对照组.但经过对症治疗均能顺利完成治疗.结论 TACE+伽玛刀能显著提高原发性肝癌破裂出血患者的近期疗效、生存质量及生存期;同时白细胞下降、肝功能损害、恶心、呕吐等不良反应也明显增加,但经过对症处理基本不影响治疗.Objective To explore the clinical effect and evaluate the toxicity of transcatheterhepatic arterial chemoembolization（TACE）combined with gamma knife treatment on patients with primary hepatic carcinoma.Methods Total 96 patients with primary hepatic carcinoma were randomly divided into two groups：Group A-TACE combined with gamma knife（combined therapy group）and Group B-gamma knife only（control group）,48 cases in each group.The short term effect,clinical benefit,survival time,and toxic side effects were copared between the two groups.Results The effective rates of groupA and group B were 92.3% and 75.0%,respectively.The clinical benefit rate in group A was much higher than group B.One year survival rate of the two groups were 88.5% and 65.3%,respectively.There was no significant difference in the decrease of hemoglobin and platelet between the two groups.The incidence of leukocyte decrease,liver function damage,nausea,vomiting in group A was much higher than that in group B,but these symptoms were cured after symptomatic treatment.Conclusions TACE combined with gamma knife can dramatically improve the short term effect,ife quality and survival time of the patients with primary hepatic carcinoma.Many symptoms such as leukocyte decrease,liver function damage,nausea,vomiting appear,but they don＇t influence the treatment after symptomatic treatment.

关 键 词：原发性肝癌 肝动脉栓塞化疗 外科手术 

分 类 号：R735.7[医药卫生—肿瘤]