肝动脉栓塞治疗自发性破裂性肝细胞癌的疗效及预后分析  

Therapeutic effect and prognosis of transcatheter arterial embolization in the treatment of spontaneously ruptured hepatocellular carcinoma

作　　者：周舟 杜伟 ZHOU Zhou;DU Wei(Department of Radiology,the First Affiliated Hospital of Dali University,Duli,Yuman Province 671000,China)

机构地区：[1]大理大学第一附属医院放射科,云南大理671000

出　　处：《实用放射学杂志》2020年第8期1297-1300,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81660300).

摘　　要：目的探讨肝动脉栓塞(TAE)治疗自发性破裂性肝细胞癌(HCC)的疗效,并分析影响患者预后的相关因素.方法选取76例自发性破裂性HCC患者为研究对象.观察患者治疗后临床疗效及治疗前后血清总胆红素(TBIL)、国际标准化比值(INR)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平.采用Cox回归分析影响自发性破裂性HCC患者预后的相关因素.结果76例自发性破裂性HCC患者经TAE治疗后均成功栓塞止血.治疗30 d后患者血清TBIL、INR、AST及ALT水平均明显低于治疗前,差异有统计学意义(P<0.05).自发性破裂性HCC患者1年、2年、3年生存率分别为60.5%、19.7%、10.5%.单因素及多因素Cox回归分析显示,Child-Pugh分级、脉管侵犯、肿瘤直径、入院时休克与患者预后密切相关.结论TAE治疗自发性破裂性HCC的疗效较好,能够改善患者肝功能,且肿瘤直径、Child-Pugh分级、脉管侵犯、入院时休克与患者预后有关.Objective To investigate the efficacy of transcatheter arterial embolization(TAE)in the treatment of spontaneously ruptured hepatocellular carcinoma(HCC),and to analyze the related factors affecting the prognosis of patients.Methods A total of 153 patients with spontaneously ruptured HCC treated were selected.The therapeutic efect of patients were recorded and the serum levels of total bilrubin(TBIL),International normalized ratio(INR).alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were observed before and after treatment.Cox rgression analysis was used to analyze the related factors afectin the prognosis of patients with spontaneously ruptured HCC.Results 76 patients with spontaneously ruptured HCC were successfully treated with TAE.After.30 days of treatment,the serum levels of TBIL,INR,AST and ALT were significantly lower than those before treatment,and the differences were satitically significant(P<0.05).The 1 year,2 years,3 years survival rates were 60.5%,19.7%and 10.5%,respectively.Cor regression analysis showed that Child-Pugh classification,vascular invasion,tumor diameter and shock at admission were closely related to prognosis of the patients.Conclusion TAE is efective in the treatment of spontancously ruptured HCC,and can improve the liver function of patients.Tumor diameter。Child-Pugh classification,vascular invasion and shock at admission are related to the prognosis of patients.

关 键 词：肝动脉栓塞 肝细胞癌 疗效 预后 

分 类 号：R815[医药卫生—放射医学] R735.7[医药卫生—临床医学]