射频消融术联合肝动脉化疗栓塞治疗原发性肝癌伴门静脉癌栓的临床效果  

Clinical effect of radio frequency ablation combined with trans catheter arterial chemoembolization in the treatment of primary liver cancer with portal vein tumor thrombus

作　　者：阮健秋[1] 陈欣 张红环[1] 杨锦钊[2] 李荣岗[3] RUAN Jianqiu;CHEN Xin;ZHANG Honghuan;YANG Jinzhao;LI Ronggang(Department of Medical Ultrasound,Jiangmen Central Hospital,Guangdong Province,Jiangmen529030,China;Department of Radiology Intervention,Jiangmen Central Hospital,Guangdong Province,Jiangmen529030,China;Department of Pathology,Jiangmen Central Hospital,Guangdong Province,Jiangmen529030,China)

机构地区：[1]广东省江门市中心医院医学超声科,广东江门529030 [2]广东省江门市中心医院放射介入科,广东江门529030 [3]广东省江门市中心医院病理科,广东江门529030

出　　处：《中国医药导报》2020年第20期25-28,33,共5页China Medical Herald

基　　金：广东省医学科学技术研究基金项目(A2017103)。

摘　　要：目的探讨射频消融术(RFA)联合肝动脉化疗栓塞(TACE)治疗原发性肝癌(PHC)伴门静脉癌栓(PVTT)的临床效果。方法回顾性选取2013年1月~2016年5月广东省江门市中心医院收治的80例PHC伴PVTT患者,根据治疗方式的不同分为研究组和对照组,每组40例。对照组给予TACE治疗,研究组则在对照组的基础上联合RFA治疗。比较两组患者疗效、肝功能、不良反应,记录两组患者随访期间生存情况。结果研究组治疗后临床总有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗后谷氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)、甲胎蛋白(AFP)均较治疗前降低,且研究组低于对照组,差异均有统计学意义(均P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。K-M生存曲线分析发现,研究组生存率明显高于对照组,差异有统计学意义(P<0.05)。结论PHC伴PVTT患者经RFA联合TACE治疗后,疗效确切,安全性好,可提高患者生存率及生存时间,改善患者肝功能。Objective To investigate the clinical effect of radio frequency ablation(RFA)combined with trans catheter arterial chemoembolization(TACE)in the treatment of primary liver cancer(PHC)with portal vein tumor thrombus(PVTT).Methods A total of 80 PHC patients with PVTT in Jiangmen Central Hospital,Guangdong Province were retrospectively selected from January 2013 to May 2016.According to different treatment methods,they were divided into the study group and the control group,with 40 patients in each group.The control group was treated with TACE and the study group was treated combined with RFA on the basis of the control group.The curative effect,liver function and adverse reactions of the two groups were compared,and the survival of the two groups during the follow-up period was recorded.Results The total clinical response rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,glutamate aminotransferase(ALT),aspartate amino transferase(AST),total bilirubin(TBil),alpha fetoprotein(AFP)in the two groups were all decreased compared with those before treatment,while the study group was lower than the control group,with statistically significant differences(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).K-M survival curve analysis found that the survival rate of the study group was significantly higher than that of the control group,with statistically significant difference(P<0.05).Conclusion PHC patients with PVTT after RFA combined with TACE treatment,the curative effect is accurate,safety is good,the survival rate and survival time of the patients can be improved,and the liver function of the patients can be improved.

关 键 词：射频消融术 肝动脉化疗栓塞 原发性肝癌 门静脉癌栓 

分 类 号：R735.7[医药卫生—肿瘤]