肝动脉化疗栓塞联合射频消融治疗乏血供大肝癌的疗效分析

发布时间：2017-12-28 19:01

  本文关键词：肝动脉化疗栓塞联合射频消融治疗乏血供大肝癌的疗效分析　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： 乏血供 肝肿瘤 化学栓塞 射频消融

【摘要】：目的肝癌是我国常见的恶性肿瘤之一,其发生及发展很大程度取决于肿瘤的血供情况,不同血供类型对其诊断、治疗方式的选择、疗效及预后判断均有重要意义。对于富血供的肝癌,肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)是被临床证实的有效治疗手段,但对于乏血供肝癌,单纯TACE治疗疗效欠佳,且易发生术后肝功能损伤及其他并发症。因此,如何提高乏血供肝癌的疗效,是临床关注的问题。本研究旨在评价和探讨TACE联合射频消融(Radiofrequency ablation,RFA)治疗晚期乏血供大肝癌的疗效。方法回顾性分析我院2008年10月-2014年7月收治的40例晚期乏血供大肝癌患者的临床资料,随机分为2组:联合治疗组(TACE联合RFA治疗,21例)、对照组(单纯TACE治疗,19例)。两组分别于术前、术后1个月抽取静脉血检测血清甲胎蛋白(alpha fetoprotein,AFP)含量;术前、术后1周、2周、3周分别检测血清谷丙转氨酶(Alanine aminotransferase,ALT)和谷草转氨酶(Aspartate transaminase,AST)含量,术前、术后1个月、3个月、6个月复查电子计算机断层扫描(Computed Tomography,CT)或磁共振成像(Magnetic Resonance Imaging,MRI)平扫加增强扫描;分析肿瘤病灶的大小、坏死程度、术后甲胎蛋白及肝功能变化来评估疗效。结果两组术前AFP、ALT、AST、肿瘤大小比较差异无统计学意义(P0.05)。各组术与前术后AFP含量对比,差异有统计学意义(P0.05)。两组术后AFP下降程度对比,差异无统计学意义(P0.05)。联合治疗组术后肿瘤缩小率和完全坏死率高于对照组(P均0.05);联合治疗组术后肿瘤进展率低于对照组(P0.05)。结论1、TACE联合RFA治疗乏血供肝癌近期疗效明显优于单纯TACE治疗。2、TACE联合RFA治疗乏血供肝癌安全可靠。
[Abstract]:Objective hepatocellular carcinoma is one of the most common malignant tumors in China. Its occurrence and development largely depend on the blood supply of the tumor. Different blood supply types are of great importance for its diagnosis, treatment options, curative effect and prognosis. Transcatheter arterial chemoembolization (TACE) is a clinically proven effective treatment for hepatocellular carcinoma with rich blood supply. However, for the patients with hepatocellular carcinoma, the effect of TACE alone is not good, and it is easy to cause liver dysfunction and other complications after operation. Therefore, how to improve the curative effect of blood supply for liver cancer is a problem of clinical concern. The purpose of this study was to evaluate and evaluate the efficacy of TACE combined with Radiofrequency ablation (RFA) in the treatment of advanced hypoxia for large liver cancer. Methods the clinical data of 40 patients with advanced hepatocellular carcinoma (HCC) who had received advanced blood transfusion in our hospital from October 2008 to July -2014 were retrospectively analyzed. They were randomly divided into 2 groups: combination therapy group (TACE combined with RFA treatment, 21 cases), control group (simple TACE treatment, 19 cases). The two groups respectively before operation and 1 months after extraction of venous blood serum alpha fetoprotein (alpha fetoprotein, AFP) content; preoperative and postoperative 1 weeks, 2 weeks and 3 weeks respectively to detect serum alanine aminotransferase (Alanine aminotransferase ALT) and aspartate aminotransferase (Aspartate transaminase, AST) content. The preoperative and postoperative 1 months, 3 months, 6 months computedtomography (Computed Tomography, CT) or magnetic resonance imaging (Magnetic Resonance, Imaging, MRI) plain and enhanced scan; analysis of tumor size, necrosis, degree of postoperative AFP and liver function change to evaluate the efficacy. Results there was no significant difference in the size of AFP, ALT, AST and tumor size before operation (P0.05) in the two groups. The difference of AFP content in each group was statistically significant (P0.05). There was no significant difference in the degree of AFP decline between the two groups (P0.05). The rate of tumor reduction and complete necrosis after operation in the combined treatment group was higher than that of the control group (P 0.05), and the tumor progression rate in the combined treatment group was lower than that of the control group (P0.05). Conclusion 1, TACE combined with RFA in the treatment of hypoxic liver cancer is better than that of TACE alone. 2, TACE combined with RFA in the treatment of hypovascular liver cancer is safe and reliable.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7
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