中央型肝细胞肝癌联合术中瘤床放疗研究及疗效初步探索
发布时间：2018-07-21 14:24
【摘要】：目的开展中央型肝细胞肝癌联合术中瘤床放疗技术,并初步探索其安全性及临床效果。方法将行开腹手术的79例中央型肝细胞肝癌患者分为实验组(联合术中瘤床放疗组,32例)和对照组(单纯手术组,47例)。实验组患者手术切除肿瘤后,于瘤床行术中电子线放疗,对照组无术中电子线放疗步骤。比较两组患者的术中、术后情况。结果两组术后30天内均无死亡病例。实验组患者的平均手术时间(319±76 min)长于对照组(233±76 min,P=0.000),实验组患者术后第1天中位AST水平(562.5U/L)高于对照组(347 U/L,P=0.031),实验组术后第3天、第7天平均 PTA 水平低于对照组(68.3±17.9%和 78.9±15.9%,P=0.007;73.4±10.2%和80±10.6,P=0.007)。两组患者肿瘤病理情况(分化程度、卫星灶、被膜侵犯、微血管侵犯)的差异均无统计学意义(均P0.05)。两组患者术后住院时间、肝功能不全、大量腹水、胸腔积液、感染、胆瘘、肠道通气时间的差异均无统计学意义(均P0.05)。两组患者术后第1、3、5、7天反映肝功能的其他实验室指标(ALT、TBIL、ALB)的差异均无统计学意义(均P0.05)。结论联合术中瘤床放疗技术增长了手术时间,减慢术后肝功能早期恢复,但仍是安全可行的。
[Abstract]:Objective to develop the tumor bed radiotherapy for the combined operation of central hepatocellular carcinoma (HCC), and to explore its safety and clinical effect. Methods 79 patients with central hepatocellular carcinoma were divided into experimental group (combined intraoperative tumor radiotherapy group, 32 cases) and control group (47 cases). The patients in the two groups had no death in 30 days after operation. The average operating time (319 + 76 min) in the experimental group was longer than that of the control group (233 + 76 min, P=0.000), and the level of AST (562.5U/L) was high at first days after operation in the experimental group. In the control group (347 U/L, P=0.031), the average PTA level of the experimental group was lower than that of the control group (68.3 + 17.9% and 78.9 + 15.9%, P=0.007, 73.4 + 10.2% and 80 + 10.6, P=0.007). There was no significant difference between the tumor pathological conditions (the degree of differentiation, the satellite, the membrane invasion, the microvascular invasion) in the two group (all P0.05). There was no significant difference in the time of hospitalization, liver dysfunction, massive ascites, pleural effusion, infection, biliary fistula, and intestinal ventilation time (all P0.05). There was no significant difference between the two groups of other laboratory indexes (ALT, TBIL, ALB) that reflected the liver function on day 1,3,5,7 after operation (all P0.05). Conclusion the combination of tumor bed radiotherapy technique in the combined operation The operation time and the early recovery of liver function after operation were slowed down, but it was still safe and feasible.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7
[Abstract]:Objective to develop the tumor bed radiotherapy for the combined operation of central hepatocellular carcinoma (HCC), and to explore its safety and clinical effect. Methods 79 patients with central hepatocellular carcinoma were divided into experimental group (combined intraoperative tumor radiotherapy group, 32 cases) and control group (47 cases). The patients in the two groups had no death in 30 days after operation. The average operating time (319 + 76 min) in the experimental group was longer than that of the control group (233 + 76 min, P=0.000), and the level of AST (562.5U/L) was high at first days after operation in the experimental group. In the control group (347 U/L, P=0.031), the average PTA level of the experimental group was lower than that of the control group (68.3 + 17.9% and 78.9 + 15.9%, P=0.007, 73.4 + 10.2% and 80 + 10.6, P=0.007). There was no significant difference between the tumor pathological conditions (the degree of differentiation, the satellite, the membrane invasion, the microvascular invasion) in the two group (all P0.05). There was no significant difference in the time of hospitalization, liver dysfunction, massive ascites, pleural effusion, infection, biliary fistula, and intestinal ventilation time (all P0.05). There was no significant difference between the two groups of other laboratory indexes (ALT, TBIL, ALB) that reflected the liver function on day 1,3,5,7 after operation (all P0.05). Conclusion the combination of tumor bed radiotherapy technique in the combined operation The operation time and the early recovery of liver function after operation were slowed down, but it was still safe and feasible.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7
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