交联葡聚糖凝胶栓塞剂肝癌栓塞治疗安全性、有效性、随机、平行对照研究

发布时间：2018-05-10 16:32

本文选题：交联葡聚糖凝胶微球颗粒 + 栓塞剂　；参考：《第四军医大学》2015年硕士论文

【摘要】：目的:比较交联葡聚糖凝胶微球颗粒栓塞剂和超液态碘化油栓塞剂对原发性肝癌的临床疗效,并对交联葡聚糖凝胶微球颗粒栓塞剂的有效性、安全性做出评价。方法:选择2012年1月至2013年1月入院治疗的原发性肝癌患者24例,包括男性患者13例,平均年龄51.8±11岁,女性患者11例,平均年龄55.2±9.5岁。采用随机双盲对照研究,将24例确诊为原发性肝癌患者分为交联葡聚糖凝胶微球颗粒栓塞组和超液态碘化油栓塞组,两组患者的年龄大小、术前瘤体面积,血清AFP阳性率等均无显著差异(P0.05)。两组患者经不同栓塞剂行TACE治疗45天后,分别观察其栓塞后瘤体缩小面积、肝功能、血常规、血清AFP水平、术后不良反应及生存率等指标变化情况,结合影像学评估交联葡聚糖凝胶微球颗粒栓塞剂的安全性及其疗效。结果:1.肿瘤缩小:研究组病灶完全缓解1例(占8.3%),部分缓解10例(占83.3%),稳定1例(占8.3%),10例患者肿瘤区出现液性坏死区(占83.3%)。对照组中无完全缓解病例,部分缓解5例(占41.7%),稳定3例(占25%),发展4例(占33.3%),3例患者肿瘤区出现液化坏死区(占25%)。相比对照组,研究组患者术后肿瘤显著缩小(P0.05)。2.血清AFP水平下降:研究组有10例患者AFP降低,而对照组有9例,且研究组AFP下降值显著高于对照组(P0.05)。3.术后不良反应及并发症:研究组平均发热天数(1.67 d)显著少于对照组(2.91 d)(P0.05),而发热人数却显著多于对照组(P0.05),研究组患者发生恶心或呕吐人数以及疼痛/II级人数均显著多于对照组(P0.05)。4.实验室检查:治疗前后,两组患者所有血清指标均无显著性变化(P0.05)。5.栓塞后180天存活率:研究组患者生存率83.33%,平行对照组患者生存率66.67%,两组均未发生严重不良反应。结论:交联葡聚糖凝胶微球颗粒栓塞剂疗肝癌安全有效,较超液态碘化油治疗效更好,患者经济负担更轻,有较好的临床治疗价值。
[Abstract]:Objective: To compare the clinical efficacy of crosslinked dextran gel microsphere particle embolism agent and super liquid iodized oil embolic agent in the treatment of primary liver cancer, and evaluate the effectiveness and safety of the crosslinked dextran gel microsphere embolic agent. Methods: 24 cases of primary liver cancer, including male patients, were selected from January 2012 to January 2013, including male patients. In 13 cases, the average age was 51.8 + 11 years, and the average age of 11 women was 55.2 + 9.5 years old. A randomized double blind control study was used. 24 cases of primary liver cancer were divided into the cross linked dextran gel microsphere embolism group and the super liquid iodized oil embolism group. The age size of the two groups, the area of the tumor before operation, and the positive rate of the serum AFP were no longer in the two groups. Significant difference (P0.05). Two groups of patients were treated with different embolic agents for 45 days. After 45 days, the tumor size, liver function, blood routine, serum AFP level, postoperative adverse reaction and survival rate were observed, and the safety and efficacy of the crosslinked dextran gel microspheres were evaluated by imaging. Results: 1 Tumor reduction: 1 cases of complete remission in the study group (8.3%), partial remission in 10 cases (83.3%), 1 cases (8.3%), 10 patients with liquid necrotic area (83.3%). In the control group, there were no complete remission cases, 5 cases (41.7%), 3 cases (25%), 4 cases (occupy 25%), and liquefied necrotic areas in the tumor area. 25%). Compared with the control group, the tumor significantly reduced (P0.05).2. serum AFP level in the study group: in the study group, there were 10 patients with lower AFP and 9 in the control group, and the AFP descent value of the study group was significantly higher than that of the control group (P0.05).3. postoperative adverse reactions and complications: the average number of fever days (1.67 d) in the study group was significantly less than that of the control group (2.91 d) (2.91 d). P0.05), but the number of fever was significantly more than that of the control group (P0.05). The number of patients with nausea or vomiting and the number of pain /II levels in the study group were significantly more than that of the control group (P0.05).4. laboratory examination: before and after the treatment, all the serum indexes of the two groups had no significant changes (P0.05) the survival rate of the.5. after.5. embolism: the survival rate of the study group was 83.33%. The survival rate of the patients in the parallel control group was 66.67% and the two groups had no serious adverse reactions. Conclusion: the crosslinked dextran gel microsphere particle embolic agent is safe and effective in the treatment of liver cancer, which is better than the super liquid iodized oil, and the patient's economic burden is lighter and has a better clinical value.

【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

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