海藻酸钠栓塞对原发性肝癌介入治疗早期肝功能损伤及并发症的影响  

Effect of sodium alginate gelation on primary hepatic carcinoma interventional treatment for early liver function damage and its complications

作　　者：顾朋[1] 黄伍奎[1] 刘墨[1] 王海林[1] 樊喜文[1] 阿不拉江[1] 袁少华[1] 刘登尧[1] 杨树法[1] 

机构地区：[1]新疆维吾尔自治区新疆医科大学附属肿瘤医院介入诊疗科/介入室,830011

出　　处：《中国实用医药》2017年第1期14-16,共3页China Practical Medicine

基　　金：新疆维吾尔自治区科技支疆项目(项目编号:201491186);新疆医科大学科研创新基金项目(项目编号:XJC2013118)

摘　　要：目的探讨海藻酸钠栓塞(海藻酸钠-TACE)对原发性肝癌(PHC)介入治疗早期肝功能损伤及并发症的影响。方法 21例接受海藻酸钠-TACE治疗的PHC患者,所有患者术前1周及术后第5天抽血检查,对肝功能做Child分级,并记录术后并发症情况,对TACE前后肝功能和并发症进行分析,探讨术后并发症与术前肝功能Child分级的关系。结果 1海藻酸钠-TACE术后第5天患者血清谷丙转氨酶(ALT)、谷草转氨酶(AST)较术前均升高,血清白蛋白(ALB)较术前降低,差异均具有统计学意义(P<0.05);而术后第5天血清直接胆红素(DBIL)、间接胆红素(IBIL)与术前比较差异无统计学意义(P>0.05)。2海藻酸钠-TACE术后出现的并发症有发热、肝区疼痛、腹胀、恶心、呕吐、乏力、腹腔积液、感染,主要为发热和肝区疼痛,分别占90.5%和76.2%,其次为乏力、恶心。3术后与术前肝功能Child分级比较差异无统计学意义(P>0.05)。4肝功能Child A级与Child B级患者术后发热、肝区疼痛、腹胀、恶心、呕吐、腹腔积液、感染发生率比较差异无统计学意义(P>0.05);肝功能Child A级乏力发生率18.2%低于肝功能Child B级80.0%,差异具有统计学意义(P<0.05)。结论 PHC患者TACE术中使用海藻酸钠栓塞,术后存在较轻的肝功能受损,不会导致术后肝功能Child分级的改变,安全性较高。Objective To explore sodium alginate gelation（sodium alginate-TACE） on primary hepatic carcinoma（PHC） interventional for interventional treatment of early liver function damage and its complications. Methods A total of 21 PHC patients received sodium alginate-TACE for treatment and serologic examinations at 1 week intraoperation and 5 day postoperative. All postoperative complications were recorded.Hepatic function and complications before and after TACE were analyzed to explore correlation of postoperative complications and intraoperative Child classification of hepatic function. Results 1 Patients had higher serum alanine aminotransferase（ALT）, aspartate aminotransferase（AST） 5 days after sodium alginate-TACE than before operation, and lower serum albumin（ALB） than before operation. Their differences had statistical significance（P〈0.05）. There were no statistically significant difference in serum direct bilirubin（DBIL）, indirect bilirubin（IBIL） 5 days after operation and before operation（P〉0.05）. 2 There were complications such as fever, liver pain, abdominal distention, nausea, vomiting, fatigue, abdominal cavity effusion and infection after sodium alginate-TACE, mainly for fever and liver pain, respectively accounting for 90.5% and 76.2%, secondly for fatigue and nausea. 3 There was no statistically significant difference in Child classification of liver function before and after operation（P〉0.05）. 4There was no statistically significant difference in incidence of postoperative fever, liver pain, abdominal distention, nausea, vomiting, abdominal cavity effusion and infection between Child class A liver function patients and Child class B liver function patients（P〉0.05）. Child class A liver function patients had lower incidence of fatigue as 18.2% than 80.0% in Child class B liver function patients, and the difference had statistical significance（P〈0.05）. Conclusion Implement of sodium alginate gelation in TACE operation for PHC patients provides light

关 键 词：海藻酸钠栓塞 原发性肝癌 介入治疗 肝功能 并发症 

分 类 号：R735.7[医药卫生—肿瘤]