TACE联合PMCT治疗巨大肝癌的临床研究

发布时间：2018-03-23 21:35

本文选题：原发性巨大肝癌　切入点：动脉化疗栓塞术　出处：《广西医科大学》2017年硕士论文

【摘要】：目的:通过回顾性研究,对比分析单独行经导管肝动脉化疗栓塞(TACE)与采用TACE联合经皮微波消融术(PMCT)治疗原发性巨大肝癌的临床疗效、预后及安全性评价。方法:收集2011年9月到2014年9月在我院住院治疗的原发性巨大肝癌(肿瘤最大直径10cm)91例病例。其中,单独采用动脉化疗栓塞术治疗的患者40例,予纳入对照组,对照组患者至少接受2次TACE治疗;TACE联合微波消融术(PMCT)治疗的患者51例,予纳入观察组,观察组患者至少在接受1次TACE治疗后,且通过临床评估肿瘤获得缩小的情况下,继续给予微波消融术,必要时可再行TACE。治疗结束后进行随访,评价两组的治疗效果、临床预后及毒副反应。结果:纳入本研究的两组患者均获得完整随访。观察组患者的完全缓解率、部分缓解率及总体有效率均高于对照组(p值均小于0.05)。两组患者治疗后Child-pugh评分均有所降低,且观察组改善更为明显(P=0.033)。观察组患者的中位生存时间为14个月,对照组中位生存时间为9个月,差异有统计学意义(P0.0013)。观察组1、2年生存率分别为60.84%、29.20%;对照组1、2年生存率分别为34.03%、18.52%。两组患者比较1年生存率(P=0.007)及2年生存率(P=0.001)差异有统计学意义。两组患者均未发生较为严重的不良反应,且两组患者不良反应的发生并无较大差异。结论:肝动脉化疗栓塞术(TACE)联合微波消融术(PMCT)治疗原发性巨大肝癌,较单独使用肝动脉化疗栓塞术能延长患者的生存时间,其疗效可靠,安全性高,具有良好的临床应用价值。
[Abstract]:Objective: to compare the clinical effects of transcatheter hepatic artery chemoembolization (TACEE) and TACE combined with percutaneous microwave ablation in the treatment of large hepatocellular carcinoma. Methods: from September 2011 to September 2014, 40 patients with large primary liver cancer (10cm)91 with maximum diameter of tumor) treated by arterial chemoembolization alone were collected. In the control group, 51 patients in the control group received at least 2 times of TACE therapy combined with microwave ablation. The patients in the observation group were treated with TACE at least once. After clinical evaluation of the reduction of the tumor, microwave ablation was continued and TACE.After the treatment was finished, the therapeutic effects of the two groups were evaluated. Clinical prognosis and side effects. Results: the two groups of patients in this study were followed up completely. The complete remission rate of the patients in the observation group, The partial remission rate and the total effective rate were higher than those of the control group (P < 0.05). The Child-pugh score of the two groups decreased after treatment, and the improvement was more obvious in the observation group than in the control group. The median survival time of the patients in the observation group was 14 months. The median survival time of the control group was 9 months. The 1- and 2-year survival rates in the observation group were 60.84 and 29.20, respectively, while the 1- and 2-year survival rates in the control group were 34.03and 18.52.The 1-year survival rate and 2-year survival rate were significantly higher than those in the control group (P 0.007) and 2-year survival rate (P0.001). There was no significant difference in the 1- and 2-year survival rates between the two groups. For serious adverse reactions, There was no significant difference between the two groups in the occurrence of adverse reactions. Conclusion: TACE combined with microwave ablation can prolong the survival time of patients with giant primary liver cancer. Its curative effect is reliable, the safety is high, has the good clinical application value.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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