经导管肝动脉栓塞化疗联合华蟾素门静脉灌注治疗中期原发性肝癌疗效研究  

Effect of portal venous perfusion cinobufacini injection combined with TACE in patients with intermediate hepatocellular carcinoma

作　　者：李淑英 吴申 陈挺松 吴孝雄 罗明 

机构地区：[1]长海医院康复医学科,上海200433 [2]同济大学附属杨浦医院中医科,上海200090 [3]上海市第七人民医院肿瘤与介入治疗科,上海200137

出　　处：《临床军医杂志》2017年第9期884-886,共3页Clinical Journal of Medical Officers

基　　金：上海市中医药事业发展三年行动计划(重大研究)(ZYSNXD-CC-ZDYJ025);上海市卫生局青年科研项目(20124Y030)

摘　　要：目的探讨经导管肝动脉栓塞化疗(TACE)联合华蟾素门静脉灌注治疗中期原发性肝癌患者的临床疗效与预后。方法选取自2011年2月至2013年11月收治的中期原发性肝癌患者79例,其中,单独应用TACE的患者40例(单独组),联合应用TACE与华蟾素门静脉灌注的患者39例(联合组)。比较两组患者存活与门静脉侵犯情况,并分析其影响因素。结果单独组与联合组患者的1年存活率分别为62.5%(25/40)与82.1%(32/39),2年存活率分别为22.5%(9/40)与35.9%(14/39),3年存活率分别为7.5%(3/40)与17.9%(7/39);中位存活时间分别为15.0个月与18.0个月;门静脉癌栓发生率分别为82.5%(33/40)与61.5%(24/39)。两组比较,差异均有统计学意义(P<0.05)。华蟾素门静脉灌注、ChildPugh分级、甲胎蛋白水平及肿瘤大小是影响患者预后的独立危险因素。结论 TACE联合华蟾素门静脉灌注治疗可明显改善中期原发性肝癌患者的预后,值得临床推广。Objective To investigate the prognosis of patients with intermediate hepatocellular carcinoma（HCC） treated with portal venous perfusion of cinobufacini injection combined with transcatheter arterial chemoembolization（TACE）.Methods A retrospective study was performed on 79 cases of patients with intermediate HCC who were admitted from February 2011 to November 2013.Among the patients,40 cases who were single treated with TACE were in the single TACE group,the others who were treated with TACE combined with portal venous perfusion of cinobufacini injection were in the combination treatment group.The survival indexes and rates of portal vein invasion were compared between the two groups.Results In the single TACE group and the combination treatment group,the survival rate in 1 year was 62.5%（25/40） and 82.1%（32/39）,in 2 years was 22.5%（9/40） and 35.9%（14/39）,and in 3years was 7.5%（3/40） and 17.9%（7/39）,respectively; the median survival time was 15.0 months and 18.0 months,respectively;the portal vein invasion rate was 82.5%（33/40） and 61.5%（24/39）,respectively.The differences between the two groups were statistically significant（P0.05）.Portal venous perfusion of cinobufacini,Child-Pugh score,serum AFP concentration,and tumor size were independent risk factors in the prognosis of patients with intermediate HCC.Conclusion TACE combined with portal venous perfusion of cinobufacini injection can significantly improve the prognosis of patients with intermediate HCC,which is worth of clinical promotion.

关 键 词：原发性肝癌 华蟾素 门静脉灌注 肝动脉栓塞化疗 

分 类 号：R735.7[医药卫生—肿瘤]