射频消融联合索拉非尼治疗中晚期肝癌对患者肝功能的影响及疗效分析  

Effect of radiofrequency ablation combined with sorafenib on liver function in patients with advanced hepatic carcinoma

作　　者：俞南松 严培军[1] 郑媛媛[2] 鲁葆春[1] YU Nan-song;YAN Pei-jun;ZHENG Yuan-yuan(Department of Hepatobiliary Surgery, Shaoxing People＇s Hospital, Shaoxing, Zhejiang 312000, China)

机构地区：[1]绍兴市人民医院肝胆外科,浙江绍兴312000 [2]绍兴市人民医院超声科

出　　处：《中华全科医学》2018年第5期754-756,共3页Chinese Journal of General Practice

基　　金：浙江省绍兴市公益性技术应用研究计划项目(2015B70055);浙江省自然科学研究基金(LY17H-030001);绍兴市卫生计生科技计划科技创新项目(2016CX007)

摘　　要：目的探讨射频消融术联合索拉非尼治疗中晚期肝癌的临床效果及对患者肝功能的影响。方法选取2013年2月—2015年11月收治的中晚期原发性肝癌患者46例为研究对象,经随机数字表法分为对照组23例、观察组23例,对照组仅行射频消融术治疗,观察组在对照组基础上结合索拉非尼治疗,观察2组治疗总有效率、治疗前后肝功能指标变化及治疗后1年、2年存活情况。结果治疗总有效率观察组为91.30%,与对照组65.22%比较,显著较高,差异有统计学意义(P<0.05);肝功能指标治疗前2组差异无统计学意义(P>0.05),治疗后2组谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBiL)均有上升,但观察组治疗后上述指标水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后1年、2年存活率分别为86.96%、78.26%,对照组治疗后1年、2年存活率分别为60.87%、47.83%,观察组显著高于对照组,差异有统计学意义(P<0.05)。结论射频消融术联合索拉非尼治疗中晚期肝癌,可获得确切疗效,患者远期存活率较高,且可减少肝功能损害,具有较高的临床应用价值。Objective To investigate the clinical effect of radiofrequency ablation combined with sorafenib in the treat- ment of advanced hepatic carcinoma. Methods Total 46 patients with advanced primary liver cancer who were treated in our hospital from February, 2013 to November, 2015 were selected and randomly divided into control group （n = 23 ） and observation group （ n = 23 ）. The control group was treated with radiofrequency ablation alone, and the observation group was treated with sorafenih on the basis of the control group. The total effective rate, the changes of liver function indexes before and after treatment, and the survival rate of the 1 and 2 years after treatment were observed between the two groups. Results The total effective rate of the observation group was 91.30%, which was significantly higher than that of the control group （65.22%） , P 〈0.05. No significant liver function index before treatment between the two groups （P 〉 0.05 ）, the two groups after treatment of Aspartate aminotransferase （ AST）, Alanine aminotransferase （ALT） and total bilirubin （TBiL） were increased, but the observation group after treatment. The above index level is lower than the control group （ P 〈 0.05 ）. The observation group after treatment for 1 years and 2 years survival rates were 86.96% , 78.26% , the control group after treatment for 1 years and 2 years survival rates were 60.87% and 47.83%. The obser- vation group was significantly higher than the control group （ P 〈 0.05 ）. Conclusion Radiofrequency ablation combined with sorafenib in the treatment of advanced liver cancer, can obtain accurate curative effect, long-term survival rate is higher, and can reduce liver function damage, has higher clinical application value.

关 键 词：肝癌 索拉非尼 射频消融术 肝功能 

分 类 号：R735.7[医药卫生—肿瘤] R730.58[医药卫生—临床医学]