摘要
目的分析精准肝动脉灌注化疗栓塞(TACE)对原发性肝癌(PHC)患者肝功能及并发症的影响。方法随机数字法将135例PHC患者分为观察组与对照组,观察组采取精准TACE治疗,对照组则行常规TACE治疗,比较两组治疗效果、X线辐射剂量、对比剂用量、介入手术时间、并发症及治疗前后肝功能指标变化情况。结果观察组治疗总有效率、X线辐射剂量、对比剂用量、胃肠道反应、骨髓抑制及肝区疼痛发生率与对照组比较差异均无统计学意义(P>0.05);观察组介入手术时间、肝功能不全发生率分别为(78.62±5.18)min、6.15%,较对照组的(64.45±9.73)min、17.14%差异有统计学意义(P<0.05);与治疗前比较,两组治疗后第3天、第5天TBIL、DBIL、SAT、ALT均显著上升,ALB水平显著下降(P<0.05),且观察组治疗后第3天、第5天上述指标与对照组比较差异显著(P<0.05)。结论 TACE治疗PHC疗效较好,相比常规TACE,精准TACE治疗PHC时间虽明显延长,但能显著减轻对患者肝功能的损害,降低肝功能不全发生率,且不增加辐射剂量及对比剂剂量,安全性更强。
Objective To analyze the effect of precise transhepatic arterial chemoembolization （TACE） on liver function and on complications in patients with primary hepatocellular carcinoma （PHC）. Methods A total of 135 patients with PHC were randomized into the observation group （treated with precise TACE） and the control group （treated with routine TACE）. The ther- apeutic effects, dose of X-ray radiation, dose of used contrast agents, duration of interventionai operation, complications and chan- ges of liver function indexes before and after treatment were compared between the two groups. Results The total effective rate, X -ray radiation dose, dose of used contrast agents, gastrointestinal reactions, bone marrow suppression and pain in the liver area showed no significant difference between the two groups （ P〉0. 05 ）. The duration of interventional operation and incidence of he- patic insufficiency were significantly different between the two groups [ （78.62±5.18） min vs （64. 45±9.73 ） min, 6. 15% vs 17. 14% ） （P〈0. 05）. TBIL,DBIL,SAT and ALT in the two groups on the 3rd and 5th day after treatment were significantly in- creased while ALB was significantly decreased （P〈0. 05 ）. The above indexes showed significant difference between the two groups （P〈0. 05）. Conclusion TACE is effective in the treatment of PHC. Despite the longer duration of precise TACE for trea- ting PHC,it can obviously alleviate the damage to liver function, significantly reduce the incidence of hepatic insufficiency, and does not increase the radiation dose and dose of contrast agents, and it is safer.
出处
《解放军预防医学杂志》
CAS
2017年第6期632-635,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
甘肃省自然科学基金资助项目(No.0710RJZA1105)
