康博刀消融联合肝动脉化疗栓塞术治疗原发性肝癌的疗效及安全性分析  

Efficacy and safety of Kangbo knife ablation combined with hepatic artery chemoembolization in treatment of primary liver cancer

作　　者：乔炳礼[1] 曹旸[1] 董耿[1] 李润花[1] 李培培 Qiao Bingli;Cao Yang;Dong Geng;Li Runhua;Li Peipei(Department of Oncology,Zhengzhou Third People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第三人民医院肿瘤科,河南郑州450000

出　　处：《齐齐哈尔医学院学报》2023年第12期1107-1111,共5页Journal of Qiqihar Medical University

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191024)。

摘　　要：目的探究康博刀消融联合肝动脉化疗栓塞术治疗原发性肝癌的疗效及安全性。方法选取2020年2月—2021年2月本院收治的中晚期原发性肝癌患者56例作为研究对象,随机分为对照组和观察组两组,每组各28例。对照组给予肝动脉化疗栓塞术进行治疗,观察组给予康博刀复合冷热消融联合肝动脉化疗栓塞术治疗。比较两组患者的治疗效果。对比分析患者治疗前后血清癌胚抗原(CEA)、甲胎蛋白(AFP)、异常凝血酶原(DCP)水平。术前及术后4周对患者行肿瘤组织CT灌注并比较总肝脏灌注量(TLP)、肝动脉灌注量(HAP)、肝灌注指数(HPI)。检测患者治疗前后患者血清CD4+、CD8+、CD4+/CD8+水平。比较两组患者术后6个月及1年生存率及毒副反应发生率。结果观察组患者治疗效果显著优于对照组(P<0.05)。经治疗,观察组患者的血清AFP、CEA、DCP水平显著低于对照组(P<0.05)。观察组患者的TLP、HAP及HPI水平显著低于对照组(P<0.05)。观察组患者治疗后CD4+、CD4+/CD8+值高于对照组,CD8+水平低于对照组(P<0.05)。术后6个月及1年观察组患者的生存率与对照组生存率比较无显著差异(P>0.05)。两组患者间各毒副反应(腹泻、发热、恶心呕吐、皮疹、尿潴留)发生率比较,差异无统计学意义(P>0.05)。结论在对原发性肝癌患者进行肝动脉化疗栓塞术时采用康博刀复合冷热消融治疗可以有效提高近期疗效,降低患者的血清肿瘤标志物水平,具有临床应用潜力。Objective To explore the efficacy and safety of Kangbo knife ablation combined with hepatic artery chemoembolization in the treatment of primary liver cancer.Methods 56 patients with advanced primary liver cancer admitted to our hospital from February 2020 to February 2021 were enrolled as study subjects,and they were randomly divided into control group and observation groups,with 28 cases in each group.The control group was treated with hepatic artery chemoembolization,while the observation group was treated with Kangbo knife combined with cold and hot ablation combined with hepatic artery chemoembolization.The therapeutic effects of the two groups were compared.The levels of serum carcinoembryonic antigen(CEA),alpha fetoprotein(AFP)and abnormal prothrombin(DCP)were analyzed before and after treatment.CT perfusion of tumor tissue was performed before operation and 4 weeks after operation and the total hepatic perfusion volume(TLP),hepatic artery perfusion volume(HAP)and hepatic perfusion index(HPI)were compared.The serum CD4+,CD8+,CD4+/CD8+ levels were measured before and after treatment.The 6-month and 1-year survival rates and incidence rate of toxic and side effects were compared between the two groups.Results The therapeutic effect of the observation group was significantly better than that of the control group(P<0.05).After treatment,the levels of serum tumor markers AFP,CEA and DCP in the observation group were significantly lower than those in the control group(P<0.05).The levels of TLP,HAP and HPI in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the CD4+,CD4+/CD8+ values of patients in the observation group were higher than those in the control group,and the level of CD8+was lower than that in the control group(P<0.05).There was no significant difference in the survival rate between the observation group and the control group at 6 months and 1 year after operation(P>0.05).There was no significant difference in the incidence rate of toxic and side e

关 键 词：康博刀复合冷热消融 肝动脉化疗栓塞术 原发性肝癌 血清肿瘤标志物 

分 类 号：R735.7[医药卫生—肿瘤]