乙型肝炎继发肝癌患者TACE术围术期使用恩替卡韦的临床观察

发布时间：2018-03-12 14:49

本文选题：肝动脉化疗栓塞术　切入点：恩替卡韦　出处：《中国药房》2017年02期 　论文类型：期刊论文

【摘要】：目的:观察乙型肝炎(以下简称"乙肝")继发肝癌患者肝动脉化疗栓塞(TACE)术围术期使用恩替卡韦辅助治疗的临床疗效及安全性。方法:选取我院2012年6月-2013年6月拟行TACE术的乙肝继发肝癌患者130例,按照随机数字表法分为对照组和观察组,各65例。对照组患者给予TACE术治疗,化疗药物方案为氟尿嘧啶注射液20 m L+盐酸表柔比星注射液10 m L加入0.9%氯化钠注射液500 m L,ivgtt;观察组患者在TACE术前1周开始给予马来酸恩替卡韦片0.5 mg,po,qd,连续治疗12个月。比较两组患者临床疗效、甲胎蛋白(AFP)水平、乙肝病毒(HBV)DNA定量、丙氨酸转氨酶(ALT)水平、日常生活质量评分和生存率,并记录不良反应发生情况。结果:治疗前,两组患者AFP水平、HBV-DNA定量、ALT水平和日常生活质量评分比较,差异均无统计学意义(P0.05)。治疗后,观察组患者治疗总有效率显著高于对照组(41.54%vs.20.00%),AFP水平、HBV-DNA定量和ALT水平明显低于对照组,日常生活质量评分明显高于对照组,差异均有统计学意义(P0.05)。观察组患者随访1、2、3年的生存率均明显高于对照组(分别为75.38%vs.52.31%、53.85%vs.29.23%、32.31%vs.15.38%),差异均有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:乙肝继发肝癌患者TACE术围术期使用恩替卡韦辅助治疗可有效控制患者疾病进展,保护肝功能,提高日常生活质量,并有助于提高总生存率,且安全性好。
[Abstract]:Objective: to observe the efficacy and safety of adjuvant treatment with entecavir during the perioperative period of hepatic arterial chemoembolization (TACEE) in patients with hepatitis B. methods: from June 2012 to 2013, 6 patients in our hospital were selected. One hundred and thirty patients with hepatitis B secondary liver cancer who were scheduled to be treated with TACE. The patients in the control group were divided into two groups: the control group (n = 65) and the observation group (n = 65). The patients in the control group were treated with TACE. The chemotherapy regimen consisted of fluorouracil injection 20 mL epirubicin hydrochloride injection 10 mL and 0.9% sodium chloride injection 500 mL iv gtt. The patients in the observation group were treated continuously with enticavir maleate 0.5 mg / L poqd one week before TACE. 12 months. The clinical efficacy of the two groups was compared. AFP level, HBV DNA quantity, alt level, quality of daily life score and survival rate, and adverse reactions were recorded. After treatment, the total effective rate of the patients in the observation group was significantly higher than that in the control group (41.54 vs.20.00%). The levels of HBV-DNA and ALT were significantly lower in the observation group than in the control group. The quality of daily life score was significantly higher than that of the control group, the difference was statistically significant (P 0.05). The survival rate of the observation group was significantly higher than that of the control group (75.38 vs 52.31 vs 53.85 vs.29.2335 vs 32.31 vs.15.380.The incidence of adverse reactions in the two groups was significantly higher than that in the control group (P 0.05). Conclusion: the adjuvant therapy of entecavir during the perioperative period of TACE can effectively control the disease progression, protect liver function, improve the quality of daily life and improve the overall survival rate in patients with hepatitis B secondary liver cancer. And the safety is good.
【作者单位】：解放军第302医院普通外科;
【分类号】：R735.7;R512.62

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