TACE治疗原发性肝癌对肝功能影响的相关因素分析  

Analysis of related factors affecting liver function for hepatocellular carcinoma after transcatheter arterial chemoembolization

作　　者：张成佳[1] 何仕诚[2] 滕皋军[2] 方文[2] 郭金和[2] 邓钢[2] 朱光宇[2] 李国昭[2] 

机构地区：[1]东南大学医学院,江苏南京210009 [2]东南大学附属中大医院放射科,江苏南京210009

出　　处：《东南大学学报（医学版）》2013年第1期18-22,共5页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨经动脉化疗栓塞术(TACE)对原发性肝癌肝功能影响的相关因素。方法:TACE治疗原发性肝癌126例。主要随访患者性别、年龄、术前肿瘤大小、肿瘤部位、病灶数目、有无假包膜、肝硬化CT分级、是否外科术后、术中碘油用量、超选择栓塞肿瘤供血支与否、术后Child-Pugh分级及TACE次数等相关数据。术后1个月肝功能不能恢复至术前Child-Pugh分级者,被认为TACE对肝功能有影响。将以上12变量因素分别赋值,采用SPSS 17.0统计分析软件包将数据进行单因素分析,P<0.05为差异有统计学意义,将单因素分析有统计学意义的结果引入多项Logistic回归模型进行分析。结果:术后1个月Child-Pugh分级不能恢复至术前水平者为20.6%(26/126),单因素分析结果显示:假包膜、超选择栓塞肿瘤供血支与否、TACE次数及肝硬化CT分级这些变量与术后肝功能变化差异有统计学意义(P<0.05),其它相关因素对术后肝功能的影响差异无统计学意义(P>0.05)。多项Logistic回归分析显示:TACE次数、栓塞血管支及有无假包膜等因素对TACE术后1个月患者肝功能恢复至术前水平影响较大。结论:TACE治疗原发性肝癌是安全的、有效的治疗方法,术后1个月患者肝功能是能否恢复的主要影响因素为TACE次数、超选择栓塞肿瘤供血支及有无假包膜。Objective： To evaluate the factors influencing on liver function in the patients with hepatocellular carcinoma after transcatheter arterial chemoembolization（TACE）. Methods： TACE was performed in 126 patients with hepatocellular carcinoma. A series of influencing factors on liver function after TACE were followed up, including sex, age, preoperative tumor size, the location of the tumor, the number of tumor, existence of sham shell, cirrhosis classification on CT, surgery history of hepatocellular carcinoma, the volume of lipiodol injected, super-selective supply artery embolization, postoperative Child-Pugh grade and the times of TACE. TACE was deemed to have an influence on liver function if it could not recover to preoperative level 1 month after TACE. SPSS 17.0 software package was used for univariate analysis and multivariate logistic regression analysis to determine the factors influencing on liver function after TACE. Results： the Child- Pugh classification can not resume to preoperative levels was 20. 6% （26/126） 1 month after TACE. Single variant analysis showed that sham shell, super-selective supply artery embolization of tumors, the times of TACE and cirrhosis classification were related to changes of Child- Pugh grade （ P 〈 0. 05 ）. Other factors weren＇t associated with changes of Child- Pugh grade. Multivariate logistic regression analysis showed that the times of TACE, super-selective supply artery embolization and sham shell were the important factors influencing on liver function at 1 month after TACE. Conclusion： TACE is a safe and effective treatment for hepatocellular carcinoma. Main factors influencing on liver function at 1 month after TACE were super-selective supply artery embolizationr and existence of sham shell.

关 键 词：原发性肝癌 动脉栓塞化疗 肝功能 多元回归分析 

分 类 号：R735.7[医药卫生—肿瘤] R730.53[医药卫生—临床医学]