TACE及PSE联合治疗对肝癌患者肝功能及微循环状态的影响  

The Effect of TACE Plus PSE on the Liver Function and Microcirculation State of Patients with HCC

作　　者：李小秋 胡奎 柴晓娜 刘新民 饶思友 张春蕾 

机构地区：[1]武警江西省总队医院传染科,江西南昌330001

出　　处：《实用放射学杂志》2003年第4期349-351,共3页Journal of Practical Radiology

摘　　要：目的　评价经导管肝动脉化疗栓塞术 (TACE)及部分脾栓塞术 (PSE)联合治疗对肝癌 (HCC)患者的肝功能及微循环状态的影响。方法　 56例确诊为原发性肝癌患者 ,经TACE及PSE联合治疗 ,观察肝功指标变化及通过ChildPugh评分评价基础肝功能状态 ;用血液分析系统及微循环显微镜检测微循环状态 ;观察患者生存期。结果　术前患者的ChildPugh评分为 5 .40± 1 .1 2 ,联合治疗后 3d、1周、2周和 4周ChildPugh评分均有升高 ,分别为 6 .89± 1 .40、6 .64± 1 .38、6 .45± 1 .50和 5 .93± 1 .58,与术前比较均有显著性差异 (Ρ <0 .0 5)。联合介入治疗后全血低切粘度增加 (Ρ <0 .0 5) ,血浆粘度增加 (Ρ <0 .0 5) ,治疗后田牛氏加权积分增加 (P <0 .0 1 )。 6、1 2、2 4个月生存率分别为 83 .5 %、63 .3 %、45 .4 %。结论　对于肝癌患者 ,TACE及PSE联合治疗是有效的治疗方法 ,可以延长患者生存期 。Objective To evaluate the effect of transcather arterial chemoembolization(TACE) plus partial spleen embolization(PSE) on the liver function and microcirculation state in patients with hepatocellular carcinoma (HCC). Methods 56 patients with final diagnosis of primary hepatocellular carcinoma received TACE plus PSE combination therapy. Baseline liver function was evaluated with Child-Pugh scores and other indicators before and after combination interventional therapy. The microcirculation state was evaluated with blood analysis system and microcirculation microscope. The survival time were recorded.Results The mean Child-Pugh score was 5.40±1.12. After the combination therapy, the Child-Pugh score was increased in all patients to 6.89±1.40 at 3 days, 6.64±1.38 at 7 days, 6.45±1.50 at 2 weeks and 5.93±1.58 at 4 weeks(Ρ<0.05). The whole blood low-shearing viscosity(Ρ<0.05), plasma viscosity(Ρ<0.05) and Tian-niu weighted integra(Ρ<0.01)were increased. The survival rate at 6, 12 and 24 months was 83.5 %, 63.3% and 45.4 %, respectively. Conclusion The combination therapy is an effective treatment for HCC with an increase of survival time, however, it may aggravate the impairment of liver function and microcirculation state.

关 键 词：TACE PSE 联合 治疗 肝癌 肝功能 微循环状态 

分 类 号：R735.705[医药卫生—肿瘤]