皮下植入式药泵肝动脉门静脉化疗栓塞对防治肝癌术后复发的临床研究  

A Study on Preventing the Recurrence of Hepatocellular Carcinoma By Hepatectomy with HACE and PVCE

作　　者：伍宏章 赵强 程立新 曹健 陈对明 张红日 黄俊明 黄智明 

机构地区：[1]广东台山市人民医院,广东台山529200

出　　处：《中国医师杂志》2001年第10期743-745,共3页Journal of Chinese Physician

摘　　要：目的　探索防治肝癌术后复发的有效方法。方法　对我院原发性肝癌进行皮下植入式药泵肝动脉门静脉化疗栓塞对防治肝癌术后复发的前瞻性临床研究。研究对象 10 3例 ,随机分治疗组 (肝切除 +皮下泵肝动脉、门静脉化疗栓塞 ) 5 2例 ,对照组 (单纯肝切除 ) 5 1例。结果　治疗组和对照组术后 1、3、5年复发率分别为13 5 %、4 6 2 %、67 3%和 19 6%、60 8%、86 2 % ,两组差异有显著性 (P <0 0 5 )。治疗组和对照组术后 1、3、5年生存率分别为 88 35 %、62 69%、32 4 6%和 80 4 %、4 4 93%、2 0 2 % ,两组间有显著性差异 (P <0 0 5 )。结论　⑴根据我们的临床观察 ,术前AFP定量与预后成相关性 ,尤其AFP >30 0 0 μg/L者预后差 ,术前AFP阴性者 ,疗效优于阳性者。⑵肝癌术后复发是影响肝癌远疗效的主要因素。本组资料显示治疗组术后复发率明显降低 ,无瘤生存期延长 ,生存率明显提高。肝动脉门静脉化疗栓塞对防治肝癌复发有明确的价值。Objective To study an effective pathway in preventing the recurrence of hepatocellular carcinoma(H.C.C) and improve the long-term curative effects.Methods 103 resectable cases of H.C.C were randomly divided into treatment group,hepatectomy plus hepatoarteria-and portal chemotherapeutics embalizations with subcutaneous pump(HACE and PVCE) group and control group(Only hepatectomy).Based on changes of α-fetoprotein(AFP) for pre-and post operation and results of'B' ultrasound and CT,hepatic artery portography,the difference of 1,3,5-year recurrence rates and survival rates between the two groups were compared.Results ⑴The recurrence rates of treatment group and control group for 1,3,5-year were 13.5%,46.2%,67.3% and 19.6%,60.8%,86.2% respectively,there was an obviously difference (P<0 05),the survival rates of 1,3,5-year were 88.35%,62.96%,32.46% respectively for the treatment group and 80.4%,44.93%,20.2% respectively,for the control group,there was also remarkably difference in the two groups(P<0 05).⑵The reduced extent of AFP of 1,3,7-day and one month of treatment group was higher than that of control group.Above 3000μg/L in serum AFP,the patients prognosis was poor,the efficacy in AFP negative patients was superior to the positive one's.⑶Recurrence of hepatocellular carcinoma was a main factor influencing long-term effectiveness.Conclusions Application of hepatectomy plus HACE and PVCE to therapy have merits of recurrence rate low,prolongation of atumor survival term,high survival rate.So the therapy of hepatectomy plus HACE and PVCE is an effective method in preventing the recurrence of hepatocellular carcinomas.

关 键 词：肝癌 复发 手术 化疗 栓塞治疗 

分 类 号：R735.7[医药卫生—肿瘤]