Child-Pugh分级对经肝动脉化疗栓塞联合射频消融术治疗的肝细胞癌患者预后的影响  

Effects of Child-Pugh grade on the prognosis of patients with hepatocellular carcinoma treated by transcatheter arterial chemoembolization combined with radiofrequency ablation

作　　者：邢通潮 祝普利 尹超 王锦江[2] XING Tong-chao;ZHU Pu-li;YIN Chao;WANG Jin-jiang(Department of General Surgery,the Fourth People＇s Hospital of Shaanxi Province,Xi＇an 710000,China;Department of General Surgery,Yah＇an People＇s Hospital,Yah＇an 716000,Shaanxi Province,China)

机构地区：[1]陕西省第四人民医院普外科,西安710000 [2]延安市人民医院普外科,陕西延安716000

出　　处：《中国肝脏病杂志（电子版）》2018年第3期27-31,共5页Chinese Journal of Liver Diseases：Electronic Version

基　　金：陕西省自然科学基金项目(2013JM4016)

摘　　要：目的探讨Child-Pugh分级对经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合射频消融术(radiofrequency ablation,RFA)治疗的肝细胞癌(hepatocellular carcinoma,HCC)患者预后的影响。方法选取2012年2月至2014年11月在陕西省第四人民医院行TACE联合RFA治疗的HCC患者,其中Child-Pugh A级48例,Child-Pugh B级50例。评估所有患者术后12个月ChildPugh评分变化以及术后3年的生存时间和复发率。结果 TACE联合RFA术后Child-Pugh A级HCC患者的Child-Pugh评分低于治疗前(t=4.791,P <0.001),而Child-Pugh B级患者与治疗前相比差异无统计学意义(t=1.635,P=0.109)。Child-Pugh A级HCC患者3年生存期和复发率与Child-Pugh B级患者差异无统计学意义(χ~2=1.836,P=0.175;χ~2=2.696,P=0.101),但生存期曲线和复发率曲线已呈现差异趋势,且Child-Pugh A组患者生存率趋向更高,复发率趋向更低。结论 TACE联合RFA术治疗早期HCC患者,可在基线肝功能较好(Child-Pugh评分5～8分)的患者中获得更好的预后。Objective To investigate the effects of Child-Pugh grade on the prognosis of patients with hepatocellular carcinoma （HCC） treated by transcatheter arterial chemoembolization （TACE） combined with radiofrequency ablation （RFA）. Methods Patients with HCC who underwent TACE combined with RFA in the Fourth People’s Hospital of Shaanxi Province from February 2012 to November 2014 were selected. Total of 48 cases were Child-Pugh A grade and 50 cases were Child-Pugh B grade. Child-Pugh score after one year, 3 years’ survival time and recurrence rate of the patients were evaluated. Results After TACE combined RFA therapy, Child-Pugh scores of patients with Child-Pugh A grade were significantly lower than those before treatment （t = 4.791, P 〈 0.001）. However, no difference on Child-Pugh scores were found in patients with Child-Pugh B grade before and after treatment （t = 1.635, P = 0.109）. Although no difference in 3 years’ survival rate and recurrence rate between patients with Child-Pugh A grade and B grade （χ 2 = 1.836, P = 0.175; χ 2 = 2.696, P = 0.101）, but the difference emerged expanding trend, which showed higher 3 years’ survival rate and lower recurrence rate in patients with Child-Pugh A grade. Conclusions Better prognosis of TACE combined RFA therapy on patients with HCC are more likely to be found in those patients with low Child- Pugh score （5～8）.

关 键 词：CHILD-PUGH分级 肝动脉化疗栓塞术 射频消融术 生存时间 复发率 

分 类 号：R735.7[医药卫生—肿瘤]