摘要
目的评价应用明胶海绵微粒经导管肝动脉化疗栓塞术(GSMs-TACE)同步部分脾栓塞术(PSE)治疗肝癌(HCC)合并脾功能亢进(脾亢)患者的安全性及临床疗效。方法收集2013年1月—2017年12月大连大学附属中山医院及北京清华长庚医院符合入组标准64例HCC合并脾亢患者为研究对象。其中GSMs-TACE联合PSE患者34例,同期单纯行GSMs-TACE患者30例。观察术后4 d、1个月AFP、血常规、肝功能等指标变化及不良反应发生率。同时评估术后1个月肿瘤客观反应率。结果 GSMs-TACE联合PSE组术后1个月患者外周血WBC、PLT与术前比较均升高,两组比较差异有统计学意义(P<0.05)。单纯GSMs-TACE组术1个月患者外周血WBC、PLT、RBC与术前比较变化不明显,与术前差异无统计学意义(P>0.05)。两组患者术后1个月肝功能与术前比较无明显差异,但术后4 d胆碱酯酶(CHE)水平较术前降低,与术前差异均有统计学意义(P<0.05),术后1个月CHE恢复至术前正常水平。两组患者术后4 d及术后1个月AFP值均较术前降低。GSMs-TACE联合PSE组和单纯GSMs-TACE组患者1个月ORR分别为85.3%和83.3%。术后两组患者不良反应以发热、腹痛、胃区不适、恶心呕吐及胸腹腔积液为主,无其他严重并发症发生。结论 GSMs-TACE联合PSE同步治疗合并脾亢原发性肝细胞癌,具有良好的安全性和近期疗效。
Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization(TACE)using gelatin sponge microparticles(GSMs)combined with simultaneous partial splenic embolization(PSE)in treating patients with hepatocellular carcinoma(HCC)complicated by hypersplenism.Methods According to inclusion criteria,a total of consecutive 64 HCC patients with hypersplenism were enrolled in this study.The patients were encountered at the Affiliated Zhongshan Hospital of Dalian University and Beijing Tsinghua Changgeng Hospital of China from January 2013 to December 2017.GSMs-TACE combined with PSE was used to treat 34 patients(combination group),and during the same period simple GSMs-TACE was adopted to treat 30 patients(simple GSMs-TACE group).The laboratory indexes,including AFP level,routine blood test,liver function,etc.,were determined at 4 days and one month after the treatment.The one-month postoperative tumor objective response rate(ORR)was evaluated.Results In the combination group,one month after the treatment both the peripheral white blood cell count and platelet count were、obviously increased when compared with the preoperative data,and the differences were statistically significant(P<0.05).In the simple GSMs-TACE group,one month after the treatment the peripheral white blood cell count,platelet count and red blood cell count showed no obvious changes when compared with the preoperative data,and the differences were not statistically significant(P〉0.05).In both groups,no statistically significant differences in hepatic functions existed behveen preoperative data and one-month postoperative ones,except cholinesterase(CHE)level,which became lower at 4 days after the treatment than preoperative one and was significantly different from the preoperative one(P<0.05),and one month after the treatment the CHE level returned to preoperative normal level.In both groups,AFP values were decreased at 4 days and 1 month after treatment if compared with the preoperative ones.One month after the treatment,the tumor ORR in the combination group and in the simple GSMs-TACE group was 85.3%and 83.3%respectively.The main postoperative adverse reactions in the two groups included fever,abdominal pain,stomach discomfort,nausea and vomiting,pleural effusion and peritoneal effusion.No other serious complications occurred.Conclusion In treating HCC complicated by hypersplenism,GSMs-TACE combined with simultaneous PSE has good safety and short-term curative effect.
作者
刘影
张立波
任志忠
岳元勋
张跃伟
LIU Ying;ZHANG Libo;REN Zhizhong;YUE Yuanxun;ZHANG Yuewei(Department of Hepatobiliary Interventional Radiology,Beijing Tsinghua Changgeng Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第1期64-69,共6页
Journal of Interventional Radiology
关键词
肝癌
脾亢
微粒栓塞剂
介入治疗
脾栓塞
hepatocellular carcinoma
hypersplenism
microparticle embolic agent
interventional therapy
splenic embolization
