摘要
目的探讨术前肝动脉化疗栓塞对肝细胞癌患者肝移植围手术期安全与短期预后的影响。方法对2016年1月～2016年12月本院行肝移植手术的48例肝细胞癌患者的临床资料进行回顾性分析,根据是否采取肝动脉化疗栓塞治疗分为两组,其中观察组24例,术前采取肝动脉化疗栓塞治疗;对照组24例,术前未采取肝动脉化疗栓塞治疗,比较两组患者的术后并发症发生率与分级,随访12～18个月,统计死亡率。结果观察组出现血管并发症4例、术后感染13例、胆道并发症1例,对照组发生血管并发症2例、术后感染11例、胆道并发症1例,差异均无统计学意义(P> 0.05);观察组未发生免疫反应性并发症,对照组免疫反应性并发症6例,差异有统计学意义(P <0.05)。两组患者的Clavien分级情况比较,差异无统计学意义(P> 0.05)。围手术期、术后1年、术后1.5年,两组患者的死亡率差异无统计学意义(P> 0.05)。结论术前对肝细胞癌患者实施肝动脉化疗栓塞治疗,不会影响肝移植围手术期的安全性和短期预后,能减少患者因免疫调节紊乱而导致的相关并发症。
Objective To investigate the effect of preoperative hepatic arterial chemoembolization on the safety and short-term prognosis of liver transplantation in patients with hepatocellular carcinoma.Methods The clinical data of 48 patients with hepatocellular carcinoma who underwent liver transplantation from January 2016 to December 2016 were retrospectively analyzed.According to whether hepatic arterial chemoembolization was used,the patients were divided into two groups.24 patients in the observation group:hepatic arterial chemoembolization was performed before operation;24 patients in the control group were not treated with transcatheter arterial chemoembolization before operation.The postoperative complication rate and grading were compared between the two groups.The follow-up period was 12-18 months,then Statistic the mortality.Results There were 4 cases of vascular complications,13 cases of postoperative infection and 1 case of biliary tract complications in the observation group.There were 2 cases of vascular complications,11 cases of postoperative infection and 1 case of biliary tract complications in the control group.The differences were not statistically significant(P>0.05);there were no immunoreactive complications in the observation group,and 6 cases of immunoreactive complications in the control group.The difference was statistically significant(P<0.05).There was no significant difference in the Clavien grading between the two groups(P>0.05).There was no significant difference in mortality between the two groups(P>0.05)in the perioperative period,1 year after surgery,and 1.5 years after surgery.Conclusion Preoperative hepatic arterial chemoembolization in patients with hepatocellular carcinoma does not affect the safety and short-term prognosis of perioperative liver transplantation,and can reduce the complications caused by immune regulation disorder.
作者
赵云峰
李锦绣
苗书斋
曲青山
ZHAO Yun-feng;LI Jin-xiu;MIAO Shu-zhai;QU Qing-shan(Organ Transplant Department of Zhengzhou People's Hospital,Zhengzhou,Henan,450003,China)
出处
《临床研究》
2018年第12期11-13,共3页
Clinical Research
关键词
肝细胞癌
术前肝动脉化疗栓塞
肝移植
围手术期安全
短期预后
hepatocellular carcinoma
preoperative hepatic arterial chemoembolization
liver transplantation
perioperative safety
short-term prognosis
