介入治疗原发性肝细胞癌合并门静脉癌栓66例的临床分析  

Clinical analysis of interventional therapy for primary hepatic carcinoma with portal vein tumor thrombus in 66 cases

作　　者：皮儒先[1] 陈平[1] 伍强[1] 段廷莉[1] 

机构地区：[1]第三军医大学大坪医院肝胆外科,重庆400042

出　　处：《胃肠病学和肝病学杂志》2014年第11期1319-1321,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨介入治疗原发性肝癌(hepatic cell carcinoma,HCC)合并门静脉癌栓(portal vein tumor thrombus,PVTT)的临床疗效与安全性。方法收集第三军医大学大坪医院收治的66例HCC患者,按照随机数字表法分为联合治疗组和经导管动脉化疗检塞术(TACE)治疗组。联合治疗组采用TACE联合门静脉化疗(PVC)治疗,TACE治疗组采用单独TACE治疗,比较两组患者的临床疗效。结果治疗半年后联合治疗组治疗的有效率和PVTT缩小率分别为72.73%和78.79%,显著高于TACE治疗组的63.64%和51.52%(P<0.05)。联合治疗组患者的中位生存时间及半年、1年、2年生存率均较TACE治疗组高(P<0.05)。1个月后联合治疗组的毒副反应发生率为36.36%,显著低于TACE治疗组的81.82%(P<0.05)。治疗半年后联合治疗组和TACE治疗组的AFP分别为(425.36±113.32)IU/ml和(725.32±113.32)IU/ml(P<0.05)。结论 TACE联合PVC治疗HCC合并PVTT可提高中、晚期HCC患者治疗的有效率,改善患者的生存质量,还可降低抗癌药所产生的毒副反应和AFP水平。Objective To investigate the efficacy and safety of the interventional treatment on hepatic cell carcinoma （HCC） with portal vein tumor thrombus （PVTT）.Methods Sixty-six cases of patients with HCC were selected,and divided into two groups：combined treatment group and TACE group according to random number table method.The clinical efficacy between two groups were compared.Results After six months,the efficiency rate and reduced rate of PVTT in combined treatment group were significantly higher than TACE group （P ＜ 0.05）.The median survival time and six months,1-year,2-year survival rates in combined group were higher than that of TACE group （P ＜0.05）.After 1 month treatment,the incidence of adverse reaction was 36.36％ in combined group,and significantly lower than TACE group （81.82％） （P ＜ 0.05）.After six months treatment,the AFP in combined group and TACE group were （425.36 ±113.32） IU/ml and （725.32 ± 113.32） IU/ml （P ＜0.05）,respectively.Conclusion TACE combined with PVC treating HCC with PVTT can improve the effective treatment in patients with advanced primary liver cancer,improve the patient＇s quality of life,and also can reduce the toxicity of anticancer drugs produced and the expression of AFP.

关 键 词：原发性肝癌 门静脉癌栓 介入治疗 临床分析 

分 类 号：R735.7[医药卫生—肿瘤]