急诊经导管动脉栓塞化疗和手术切除治疗原发性肝癌破裂大出血患者的临床疗效  

Clinical efficacy of emergency transcatheter arterial chemoembolization and surgical resection in patients with primary liver cancer rupture and massive bleeding

作　　者：王利英 裴军强 徐江 WANG Liying;PEI Junqiang;XU Jiang(Department of Emergency Medicine,Xianyang Central Hospital,Xianyang 712000,Shaanxi,China;120 Emergency Center,Xianyang Central Hospital,Xianyang 712000,Shaanxi,China)

机构地区：[1]咸阳市中心医院急诊医学科,陕西咸阳712000 [2]咸阳市中心医院120急救中心,陕西咸阳712000

出　　处：《癌症进展》2023年第18期2058-2061,共4页Oncology Progress

基　　金：咸阳市2019年重点研发计划(2019k02-94)。

摘　　要：目的对比急诊经导管动脉栓塞化疗(TACE)和手术切除治疗原发性肝癌破裂大出血患者的临床疗效。方法根据急诊治疗方法的不同将102例原发性肝癌破裂大出血患者分为观察组(n=53,TACE治疗)和对照组(n=49,手术切除治疗)。比较两组患者的止血效果、血清肿瘤标志物[热休克蛋白90α(HSP90α)、甲胎蛋白(AFP)]水平、并发症发生情况及随访3年预后情况。结果治疗1周后,两组患者收缩压、舒张压、血红蛋白均高于本组治疗前,观察组患者收缩压、舒张压、血红蛋白水平均高于对照组,差异均有统计学意义(P﹤0.05)。治疗前后,两组患者HSP90α、AFP水平比较,差异均无统计学意义(P﹥0.05)。治疗1周后,两组患者HSP90α、AFP水平均低于本组治疗前,差异均有统计学意义(P﹤0.05)。两组患者1、3年生存率及3年复发率比较,差异均无统计学意义(P﹥0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论急诊TACE和手术切除对原发性肝癌破裂大出血患者的治疗效果均较好,但手术切除治疗受较多限制,需结合多种因素,采取相对有效的治疗方案。Objective To compare the clinical efficacy of emergency transcatheter arterial chemoembolization(TACE)and surgical resection in patients with primary liver cancer rupture and massive bleeding.Method A total of 102 patients with primary liver cancer rupture and massive bleeding were divided into observation group(n=53,received TACE treatment)and control group(n=49,received surgical resection treatment)according to different emergency treatment methods.The hemostatic effect,serum tumor markers[heat shock protein 90α(HSP90α),α-fetal protein(AFP)]levels,complications,and 3-year follow-up prognosis of the two groups were compared.Result One week after the treatment,the systolic blood pressure,diastolic blood pressure,and hemoglobin level in the two groups were higher than those before the treatment,and the above indicators in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Before and after the treatment,there were no significant differences in the levels of HSP90αand AFP between the two groups(P>0.05).One week after the treatment,the levels of HSP90αand AFP in the two groups were lower than those before the treatment,and the differences were statistically significant(P<0.05).There were no significant differences in the 1-and 3-year survival rates and 3-year recurrence rates between the two groups(P>0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Both emergency TACE and surgical resection have good therapeutic effects in patients with primary liver cancer rupture and massive bleeding.However,surgical resection treatment is subject to many restrictions and requires a combination of multiple factors to adopt a relatively effective treatment plan.

关 键 词：经导管动脉栓塞化疗 手术切除 原发性肝癌破裂大出血 临床疗效 

分 类 号：R735.7[医药卫生—肿瘤]