经皮肝动脉热化疗灌注联合栓塞治疗原发性肝癌的应用研究  

Research on transcatheter arterial thermo-chemotherapy and thermo-lipiodol embolization applied to hepatocellular carcinoma

作　　者：张木根[1] 陈鹏[1] 祝成亮[2] 

机构地区：[1]解放军第92医院介入血管外科,福建南平353000 [2]武汉大学人民医院检验科,湖北武汉430060

出　　处：《临床军医杂志》2013年第5期500-502,共3页Clinical Journal of Medical Officers

基　　金：国家自然科学基金(81101485)

摘　　要：目的探讨经皮肝动脉热化疗灌注联合栓塞治疗原发性肝癌的应用价值。方法将68例原发性肝癌患者按随机数字表法随机分为对照组(32例)与观察组(36例)。给予观察组肝动脉置管,使用5-氟尿嘧啶、顺铂、丝裂霉素及表阿霉素行热灌注化疗栓塞。对照组在常温下进行导管灌注化疗栓塞。比较两组治疗后1年及2年生存率、近期治疗效果、肝功能改变以及不良反应发生率。结果观察组1年和2年生存率为75.0%和58.3%,显著高于对照组的56.3%和28.1%(P<0.05);观察组与对照组治疗总有效率分别为55.6%和31.3%,差异具有统计学意义(P<0.05);两组治疗后肝功能Child分级无统计学差异(P>0.05);治疗后观察组局部烧灼感发生率高于对照组(P<0.05),其余不良反应两组比较无统计学差异(P>0.05)。结论经皮肝动脉热化疗灌注联合栓塞可显著提高患者生存率,且安全有效。Objective To explore the effect of transcatheter arterial thermo-chemotherapy and thermo-lipiodol embolization on hepa- tocellular carcinoma. Methods Sixty-eight patients with hepatocellular carcinoma were divided into control group （ n = 32） and trial group （ n = 36） at random. A catheter was set into the selected hepatic artery via femoral artery. The trial group was given ther- mo-chemotherapy [ 5-fluorouracil （ 5-Fu）, cis-diamminedichloroplatinum （ cis-DDP）, mitomycin and epirubicin ] and thermo-lipiodol embolization, and the control group received normal temperature chemotherapy and lipiodol embolization. Comparison was done on short-term therapeutic effect, liver function change, adverse reaction and 1-and 2-year survival rate between the two groups. Results The survival rate of 1-and 2-year was 75.0% and 58.3% in the trial group were, much higher than that （56.3% and 28.1% ） in the con- trol group （P 〈0.05）. The effective rate was 55.6% in the trial group and 31.3% in the control group, between which there exis- ted a significant difference （ P 〈 0.05 ）. There was no significant difference in Child classification of liver function between the two groups after treatment （ P 〉 0.05）. The occurrence of feeling of cauterization was more common in the trial group than in the control group （P 〈 0.05 ）, but the other adverse reactions were of no statistical difference （P 〉 0.05 ）. Conclusion Transcatheter arterial thermo-chemotherapy plus thermo-lipiodol embolization can greatly improve clinical effect on hepatocellular carcinoma, and it＇ s safe.

关 键 词：原发性肝癌 热化疗 栓塞 

分 类 号：R735.7[医药卫生—肿瘤]