肝动脉灌注化疗栓塞联合高强度聚焦超声治疗中晚期原发性肝癌的临床观察  

Clinical Observation of TACE Combined with HIFU in the Treatment of Middle and Advanced Primary Hepatocellular Carcinoma

作　　者：付斯瑜[1] 任汝仙[1] 王美江[1] 陈奕霖[1] 蒋保华[1] 张琴[1] 

机构地区：[1]遵义市第一人民医院肿瘤科,贵州遵义563002

出　　处：《中国药房》2015年第35期4978-4980,共3页China Pharmacy

摘　　要：目的：观察肝动脉灌注化疗栓塞（TACE）联合高强度聚焦超声（HIFU）治疗中晚期原发性肝癌的疗效及安全性。方法：76例中晚期原发性肝癌患者,按随机数字表法分成治疗组36例和对照组40例。对照组患者单纯采用TACE治疗,治疗组患者于TACE后2-3周加用HIFU治疗。比较两组患者的临床疗效、手术前后甲胎蛋白（AFP）含量、生存率、生存期及不良反应。结果：治疗组患者的显效率和总有效率分别为61.1%、94.4%,均显著高于对照组（35.0%、77.5%）,差异有统计学意义（P〈0.05）。两组患者治疗后的AFP含量均较治疗前显著下降,差异有统计学意义（P〈0.05）,组间比较差异也有统计学意义（P〈0.05）。治疗组患者在术后24、36个月的生存率均高于对照组,差异有统计学意义（P〈0.05）。治疗组患者的中位生存期为11.3个月,长于对照组的9.2个月,但组间比较差异无统计学意义（P〉0.05）。两组患者均未发生严重不良反应。结论：相较于单纯TACE,TACE联合HIFU治疗中晚期原发性肝癌能提高患者远期生存率和近期疗效,且安全性较好。OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization（TACE）combined with high intensity focused ultrasound（HIFU） in the treatment of middle and advanced primary hepatocellular carcinoma（HCC）. METHODS：76 patients with middle and advanced primary HCC were randomly divided into treatment group（36 cases）and control group（40 cases）. Control group was given TACE alone,and treatment group was additionally given HIFU 2-3 weeks after TACE. Clinical efficacy,the content of alpha-fetoprotein（AFP）before and after operation,survival rate,survival period and ADR were compared between 2 groups. RESULTS：The efficiency rate and total effective rate of treatment group were 61.1% and94.4%,which were significantly higher than those of control group（35.0%,77.5%）,with statistical significance（P〈0.05）. The content of AFP in 2 groups decreased significantly after operation,with statistical significance（P〈0.05）;there also was statistical significance between 2 groups（P〈0.05）. Survival rate of treatment group was higher than that of control group 24 and 36 months after operation,with statistical significance（P〈0.05）. The median survival time was 11.3 months in treatment group and 9.2month in control group,with no statistical difference（P〉0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS：Compared with TACE alone,TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term survival rate and the short-term efficacy,with good safety.

关 键 词：肝动脉灌注化疗栓塞 高强度聚焦超声 中晚期肝癌 疗效 安全性 

分 类 号：R735.7[医药卫生—肿瘤] R730.41[医药卫生—临床医学]