肝动脉栓塞化疗联合超声引导下微波消融序贯治疗原发性肝癌的时间节点研究  

Time node study of sequential treatment of primary hepatocellular carcinoma by hepatic artery embolization chemotherapy combined with microwave ablation guided by ultrasound

作　　者：张明[1] 黄君[1] 肖华旭 易礼俊 ZHANG Ming;HUANG Jun;XIAO Hua-xu(Department of General Surgery,The First People's Hospital of Yibin,Yibin Sichuan 644000,China.)

机构地区：[1]宜宾市第一人民医院普通外科,四川宜宾644000

出　　处：《临床和实验医学杂志》2021年第10期1080-1083,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:817024081)。

摘　　要：目的研究肝动脉栓塞化疗(TACE)联合超声引导经皮微波消融(PMWA))序贯治疗原发性肝癌的时间节点。方法采用回顾性分析,研究对象为2019年1月至2020年1月入院的72例原发性肝癌患者,根据TACE联合PMWA序贯治疗的不同时间点分为研究组(36例)与对照组(36例);研究组于行TACE后1周联合PMWA治疗,对照组于TACE后4周联合PMWA治疗。比较2组治疗前后肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(AST)、天冬氨酸氨基转移酶(ALT)、白蛋白(ALB)]水平变化与治疗后疾病控制率、并发症发生率。结果治疗前,2组患者肝功能指标水平比较,差异无统计学意义(P>0.05)。治疗后,研究组TBIL、AST、ALT水平分别为(56.32±4.07)μmol/L、(82.91±12.54)U/L、(69.82±10.04)U/L,均明显高于对照组[(51.24±3.58)μmol/L、(71.23±10.54)U/L、(59.35±10.14)U/L],ALB(22.53±2.41)g/L水平明显低于对照组[(25.08±2.39)g/L],差异均有统计学意义(P<0.05)。研究组患者的疾病控制率(94.44%)明显高于对照组(75.00%),差异有统计学意义(P<0.05)。研究组治疗后并发症发生率(19.44%)高与对照组(8.33%),但差异无统计学意义(P>0.05)。结论与TACE治疗后4周联合PMWA相比,原发性肝癌治疗中TACE治疗后1周联合PMWA的疾病控制率更高,但并发症发生风险略高,且对肝功能产生的影响略大。Objective To study the timing of transcatheter arterial chemochemotherapy(TACE)combined with ultrasoundguided ercutaneous microwave ablation(PMWA)for treatment of primary liver cancer sequential.Methods The retrospective analysis method was selected,and the study subjects were 72 patients with primary liver cancer admitted from January 2019 to January 2020.According to the different time points of TACE combined with PMWA sequential treatment,they were divided into study group(n=36)and control group(n=36);the study group was treated with PMWA 1 week after TACE,and the control group was treated with PMWA 4 weeks after TACE.Compare the changes of liver function index[the total bilirubin(TBIL),alanine aminotransferase(AST),aspartate aminotransferase(ALT),albumin(ALB)]levels before and after treatment,disease control rate and complication rate after treatment between the two groups.Results Before treatment,there was no significant difference in liver function index levels between the two groups(P>0.05).After treatment,the levels of TBIL,AST,and ALT in the study group were(56.32±4.07)μmol/L,(82.91±12.54)U/L,and(69.82±10.04)U/L,respectively,which were significantly higher than those in the control group[(51.24±3.58)μmol/L,(71.23±10.54)U/L,(59.35±10.14)U/L],the level of ALB(22.53±2.41)g/L in the study group was significantly lower than thart in the control group[(25.08±2.39)g/L],the differences were statistically significant(P<0.05).The disease control rate of patients in the study group(94.44%)was significantly higher than the control group(75.00%),the difference was significant(P<0.05);The incidence of complications after treatment in the study group(19.44%)was higher than that in the control group(8.33%),but the difference was not significant(P>0.05).Conclusion Compared with the combination of PMWA at 4 weeks after TACE treatment,the combination of PMWA at 1 week after TACE treatment has a higher disease control rate,but the risk of complications is slightly higher,and the effect on liver function is slightl

关 键 词：原发性肝癌 肝动脉栓塞化疗 超声引导经皮微波消融 序贯治疗 时间节点 

分 类 号：R735.7[医药卫生—肿瘤]