肝脏放射性粒子植入对肝癌患者肝功能及血常规的影响

Effect of radioactive seed implantation on liver function and bone marrow function in patient with hepatocellular carcinoma

目的探讨经CT导向下放射性粒子植入治疗肝癌对于患者肝功能及骨髓造血功能的影响。方法纳入30例晚期肝癌患者,给予CT引导下125I放射性粒子植入治疗,观察比较治疗前及治疗后2个月患者肝功能Child-Pugh分级及血常规的变化情况。结果经非参数检验统计,30例患者肝功能Child-Pugh分级及白细胞骨髓抑制分级治疗前后比较均有显著性差异(P均<0.05);单次植入70粒以上患者13例,术前术后肝功Child-Pugh分级及白细胞骨髓抑制分级有显著性差异(P均<0.05);单次植入少于70粒患者17例,术前术后肝功Child-Pugh分级比较无显著性差异(P>0.05)。按照WHO骨髓抑制分级,治疗前后血红蛋白、血小板计数经非参数检验无显著性差异(P均>0.05)。结论肝癌大剂量植入放射性粒子对于肝功能、白细胞均有一定程度影响,而对血红蛋白、血小板无明显影响。

Objective It is to approach the influence of radioactive seed implantation on liver function and bone marrow function in patients with hepatocellular carcinoma.Methods Thirty patients with advanced liver cancer were enrolled and received 125I radioactive seed implantation under CT guidance.Changes of liver function classification and blood test were compared before and after treatment.Results There was significant difference on Child-Pugh classification of 30 patients（P=0.03） after treatment.Among these,there was significant difference（P=0.025） in liver function of 13 patients who received 70 granules or above implanted once;while there was no significant difference（P=0.317） in 17 patients who received less than 70 granules implanted once.There was significant difference on leukocyte count of 30 patients（P=0.012） after treatment.Among these,there was significant difference（P=0.025） in 13 patients who received 70 granules or above implanted once;while there was no significant difference（P=0.132） in 17 patients who received less than 70 granules implanted once.There was no significant difference on postoperative hemoglobin,platelet count compare with before.Conclusion Radioactive seed implantation can affect liver function and leukocyte count of patients with liver cancer,especially high-dose implantation of radioactive granules.