手术前后经肝动脉化疗治疗原发性肝癌的临床观察  

The clinical observation of hepatic arterial chemotherapy before and after treatment of primary liver cancer

作　　者：张建刚[1] 叶知锋[1] 郭俊华[1] 李勇[1] 叶冠雄[2] 

机构地区：[1]杭州市中医院肿瘤科,浙江杭州310007 [2]浙江省丽水市人民医院肝胆外科,浙江丽水323000

出　　处：《中国现代医生》2016年第1期88-91,共4页China Modern Doctor

基　　金：浙江省科技厅公益性技术应用研究项目(2012C33034)

摘　　要：目的探讨原发性肝癌患者在手术前后经肝动脉化疗的临床治疗效果。方法选择我院2004年4月~2012年1月收治的86例原发性肝癌患者作为研究对象,随机分为对照组43例,单用手术方案治疗;观察组43例,手术前后均实施肝动脉化疗,对两组患者治疗后的临床效果及生存率情况进行比较。结果观察组治疗总有效率76.74%,明显较对照组的58.14%高,差异有统计学意义（P〈0.05）;治疗前两组患者的AFP水平无差异,经治疗后明显改善,但观察组治疗后的AFP水平明显低于对照组（P〈0.05）;术后随访3年,对术后3个月、1年、3年的生存率进行比较,观察组分别为97.67%、79.07%、60.47%,对照组为95.35%、93.02%、83.72%,两组比较,差异有统计学意义（P〈0.05）;观察组术后复发率为20.93%,对照组为11.63%,观察组胃肠道反应与血液反应明显高于对照组（P〈0.05）。结论原发性肝癌患者实施手术前后肝动脉化疗方案具有一定的毒副反应,虽然近期疗效较好,但复发率高,远期疗效较差,手术切除疗法依然是原发性肝癌的首选方法。Objective To investigate the clinical effect of hepatic arterial chemotherapy before and after treatment in treating primary liver cancer patients. Methods A total of 86 cases of primary liver cancer patients treated in our hospital from April 2004 to January 2012, were chosen as study objectives and randomly divided into the control group of43 patients with surgery alone, and the observation group with liver arterial chemotherapy both before and after surgery.The clinical efficacy and survival rate of two groups of patients after treatment were compared. Results The total effective rate in the observation group was 76.74%, significantly higher than 58.14% in the control group, the difference was statistically significant（P〈0.05）. There was no significant difference of AFP level between the two groups of patients before treatment, and there was a significant improvement after treatment. But AFP level in the observation group after treatment was significantly lower than that in the control group（P〈0.05）. Postoperative follow-up for 3 years was conducted, and the survival rates after three months, 1 year and 3 years were compared. The survival rates of the observation group after three months, 1 year and 3 years were 97.67%, 79.07% and 60.47%, respectively, and the survival rates of the control group after three months, 1 year and 3 years was 95.35%, 93.02% and 83.72%, respectively, with significant differences（P 0.05）. The recurrence rate of the observation group was 20.93%, and that in the control group was 11.63%. The gastrointestinal reaction and the blood reaction of the observation group were significantly higher than those in the control group, and the differences were statistically significant（P〈0.05）. Conclusion Hepatic artery chemotherapy before and after treatment in patients with primary liver cancer has certain side effects, with good shortterm effect, high recurrence rate and poor long-term outcome. So, resection surgery is still the preferred treatment method of primary liver ca

关 键 词：肝动脉化疗 原发性肝癌 肝动脉 毒副反应 

分 类 号：R735.7[医药卫生—肿瘤]