DEB-TACE治疗肝功能Child-Pugh评分8分肝细胞癌的疗效评价  

Evaluation of the Therapeutic Effect of DEB-TACE for the Treatment of Hepatocellular Carcinoma in Child-Pugh Score 8

作　　者：卞帅 石奇[1] 谢志江 周旭升 汪磊 朱敏 戴家应[1] BIAN Shuai;SHI Qi;XIE Zhijiang;ZHOU Xusheng;WANG Lei;ZHU Min;DAI Jiaying(Department of Interventional Therapy,Anqing Municipal Hospital,Anqing Anhui 246004,China)

机构地区：[1]安庆市立医院介入治疗科,安徽安庆246004

出　　处：《中国卫生标准管理》2024年第7期105-109,共5页China Health Standard Management

基　　金：安庆市2021年自筹经费科技计划项目(2021Z2006)。

摘　　要：目的探讨对于肝功能Child-Pugh评分8分的肝细胞癌使用载药微球经肝动脉化疗栓塞术(drug-eluting beads-transarterial chemoembolization,DEB-TACE)治疗的疗效。方法选取2021年11月—2022年11月安庆市立医院连续纳入20例肝功能Child-Pugh分级B级8分的肝癌患者,均接受DEB-TACE治疗。分析患者治疗前后肝功能及发生不良反应的情况。结果20例患者均行CalliSpheres载药微球进行治疗,过程顺利。术后1个月,患者治疗效果为疾病进展(progressive disease,PD)2例、部分缓解(partial response,PR)11例、完全缓解(complete response,CR)2例、疾病稳定(sable disease,SD)5例,且客观缓解率(objective response rate,ORR)为65.0%(13/20)。7例后续接受了靶免系统治疗。术后1周天门冬氨酸氨基转移酶(aspartate transaminase,AST)、总胆红素和谷氨酸氨基转移酶(alanine transaminase,ALT)水平都有所上升,与术前相比,差异有统计学意义(P<0.05);白蛋白水平变化较术前差异无统计学意义(P>0.05)。与术前对比,经手术治疗1个月后,患者的肝功能基本恢复至正常水平,差异无统计学意义(P>0.05)。患者仅发生了轻微不良反应,如疼痛、发热、恶心、呕吐等。结论DEB-TACE治疗肝功能Child-Pugh评分8分的肝细胞癌的近期疗效确切、安全性高。Objective To analyze and study the therapeutic effect of DEB-TACE on hepatocellular carcinoma with a Child Pugh score 8 in liver function.Methods From November 2021 to November 2022,a total of 20 cases of liver cancer with Child-Pugh grade B score 8 were continuously enrolled in Anqing Municipal Hospital,and all of them received DEB-TACE treatment.The changes of liver function and adverse reactions before and after treatment were analyzed.Results All 20 cases in this group were treated with CalliSpheres drug-loaded microspheres,and the process was smooth.One month after surgery,2 cases had disease progression(PD),11 cases partial response(PR),2 cases complete response(CR),and 5 cases stable disease(SD),and the objective response rate(ORR)was 65.0%(13/20).7 cases received target immune system therapy.The levels of aspartate transaminase(AST),total bilirubin,and alanine transaminase(ALT)all increased one week after surgery,and the differences were statistically significant.Comparison of changes in albumin levels,there was no statistically significant difference(P>0.05).Compared with preoperative treatment,after one month of surgical treatment,the patient's liver function basically returned to normal levels,and the difference was not statistically significant(P>0.05).The patient had only mild adverse reactions,such as pain,fever,nausea,vomiting,etc.Conclusion The short-term efficacy of DEB-TACE in the treatment of hepatocellular carcinoma with liver function Child-Pugh score of 8 is accurate and safe.

关 键 词：肝癌 肝动脉化疗栓塞术 CalliSpheres载药微球 天门冬氨酸氨基转移酶 谷氨酸氨基转移酶 完全缓解 

分 类 号：R735[医药卫生—肿瘤]