肝动脉化疗栓塞联合微波消融治疗肝细胞癌患者的效果  

Treatment Effect of Transcatheter Arterial Chemoembolization Combined with Microwave Ablation in Patients with Hepatocellular Carcinoma

作　　者：秦春堂[1] 薛丹[2] 陈卫斌 吴保江 徐栋 郭天利[2] 吕朝阳[1] QIN Chuntang;XUE Dan;CHEN Weibin;WU Baojiang;XU Dong;GUO Tianli;LÜ Chaoyang(Intervention Center,Jiaozuo Second People’s Hospital,Jiaozuo 454100,China;Interventional Center Ward,Jiaozuo Second People’s Hospital,Jiaozuo 454100,China)

机构地区：[1]焦作市第二人民医院介入中心,河南焦作454100 [2]焦作市第二人民医院介入中心病房,河南焦作454100

出　　处：《河南医学研究》2024年第20期3717-3720,共4页Henan Medical Research

基　　金：河南理工大学基本科研业务费青年探索创新性基金(NSFRF230423)。

摘　　要：目的 肝动脉化疗栓塞(TACE)联合微波消融(MWA)治疗肝细胞癌(HCC)患者的效果。方法 回顾性收集2020年12月至2023年12月焦作市第二人民医院收治的80例HCC患者的病例资料,按治疗方案分组。接受TACE联合MWA治疗的40例患者为TACE联合MWA组,接受TACE治疗的40例患者为TACE组。对比两组疗效、治疗前及治疗后3个月肝功能[直接胆红素(D-Bil)、白蛋白、总胆红素(T-Bil)]、肿瘤标志物[α-L-岩藻糖苷酶(AFU)、癌胚抗原(CEA)、甲胎蛋白(AFP)]、血管生成因子[血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)]水平、不良反应发生率。结果 与TACE组疾病控制率80.00%(32/40)对比,TACE联合MWA组97.50%(39/40)更高(P<0.05);两组治疗后3个月血清白蛋白水平较治疗前升高,D-Bil、T-Bil水平降低,且与TACE组对比,TACE联合MWA组血清白蛋白水平更高,D-Bil、T-Bil水平更低(P<0.05);治疗后3个月两组血清AFU、CEA、AFP水平较治疗前降低,相比TACE组,TACE联合MWA组更低(P<0.05);治疗后3个月两组血清PDGF、VEGF水平较治疗前降低,相比TACE组,TACE联合MWA组更低(P<0.05);两组食欲下降、恶心呕吐、脱发、腹泻等不良反应发生率差异无统计学意义(P>0.05)。结论 TACE联合MWA治疗HCC患者可进一步提升效果,改善肝功能,降低肿瘤标志物水平,抑制血管生成因子生成,且不明显增加不良反应。Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE)combined with microwave ablation(MWA)in the treatment of hepatocellular carcinoma(HCC).Methods The clinical data of 80 patients with HCC in Jiaozuo Second People’s Hospital from December 2020 to December 2023 were retrospectively collected and divided into two groups according to treatment schemes.Among them,40 patients who received TACE combined with MWA treatment were classified as TACE combined with MWA group,and 40 patients who received TACE treatment were classified as TACE group.The curative effects of the two groups were compared,as well as the levels of liver function[direct bilirubin(D-Bil),albumin,total bilirubin(T-Bil)]and tumor markers[α-L-Fucosidase(AFU),carcino embryonic antigen(CEA),alpha-fetoprotein(AFP)],angiogenic factor[vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF)]before and 3 months after treatment,the incidence of adverse reactions was also compared between the two groups.Results The disease control rate in TACE combined with MWA group was 97.50%(39/40),which was higher than that in TACE group[80.00%(32/40)](P<0.05).At 3 months after treatment,serum albumin levels of the two groups were higher than before treatment,while the levels of D-Bil and T-Bil were lower,compared with TACE group,serum albumin level in TACE combined with MWA group was higher,while the levels of D-Bil and T-Bil were lower(P<0.05).The levels of serum AFU,CEA and AFP in the two groups after 3 months of treatment were lower than those before treatment,and the TACE combined with MWA group were lower than those in the TACE group(P<0.05).After 3 months of treatment,the levels of serum PDGF and VEGF in the two groups were lower than those before treatment,and compared with TACE group,the levels of serum PDGF and VEGF in TACE combined with MWA group were lower(P<0.05).There was no statistical difference in the incidence of adverse reactions such as loss of appetite,nausea and vomiting,hair loss,diarrhea between

关 键 词：肝细胞癌 肿瘤标志物 肝功能 不良反应 血管生成因子 

分 类 号：R735.7[医药卫生—肿瘤]