明胶海绵颗粒联合碘油动脉栓塞治疗弥漫性/巨块型大肝癌的临床疗效评价

Gelatin sponge particles combined with lipiodol transcatheter arterial embolization in the treatment of diffuse clinical evaluation/giant blocks of large hepatocellular carcinoma

目的探讨明胶海绵颗粒联合碘油动脉栓塞治疗弥漫性/巨块型大肝癌的临床应用价值。方法 41例弥漫性/巨块型大肝癌患者根据治疗方案不同分为两组:A组(22例)予单纯碘油肝动脉化疗栓塞(TACE)治疗;B组(19例)予碘油肝动脉化疗栓塞后联合明胶海绵颗粒栓塞治疗。分别对两组患者肿瘤大小的改变情况以及栓塞术后并发症发生率进行比较。结果明胶海绵颗粒联合碘油组患者肿瘤缩小程度及AFP阳性患者AFP值下降均较单纯碘油组明显(P1=0.0027,P2=0.001);两组术后并发症发生率差异无统计学意义(P=0.644)。结论明胶海绵颗粒联合碘化油动脉栓塞治疗弥漫性/巨块型大肝癌较单独使用碘化油栓塞更有效,是治疗弥漫性/巨块型大肝癌安全、有效的方法。

Objective To investigate the gelatin sponge particles combined with lipiodol transcatheter arterial embolization in the treatment of diffuse clinical application value/giant blocks of large hepatocellular carcinoma. Methods All 41 cases of diffuse/huge liver cancer were randomly divided into two groups： group A（22 cases） treated with lipiodol transcatheter arterial chemoembolization（TACE） treatment; group B（19 cases） treated with lipiodol transcatheter arterial chemoembolization combined with gelatin sponge embolization. The two treatment group patients and the changes of liver function, serum alpha fetoprotein in January after 1 week of treatment and after treatment（AFP） level and the changes of tumor size and the incidence of complications were compared after embolization. Results The treatment in January two groups of liver function indexes had no significant difference; gelatin sponge particles combined with lipiodol group of patients with tumor size and AFP in patients with positive AFP values decreased than those of pure lipiodol group significantly（P1=0.0027, P2=0.001）; in the two group the incidence of postoperative complications were not statistically significant（P=0.644）. Conclusion Gelfoam lipiodol embolization treatment of diffuse/giant blocks of large hepatocellular carcinoma using lipiodol embolization alone is more effective, is safe and effective method of diffuse/bulky large hepatocellular carcinoma the treatment.