化疗联合冷循环射频消融术治疗原发性肝癌的效果分析

Clinical Study of Chemotherapy Combined with Cool-tip Radiofrequency Ablation in Treating Primary Liver Cancer

目的:探讨化疗联合冷循环射频消融术治疗原发性肝癌的疗效及安全性。方法:108例原发性肝癌患者随机分为两组,均给予灌注化疗,每4周进行一次灌注化疗,对照组(n=54)进行3次,治疗组(n=54)只进行一次。治疗组给予冷循环射频消融术。评价生活质量Karnofsky评分,治疗前后检查患者的血、尿、便常规,肝肾功能(包括天冬氨酸转氨酶、丙氨酸转氨酶(ALT)、白蛋白(ALB)、总胆红素、肌酐及尿素氮等指标),甲胎蛋白(AFP),T细胞亚群和加强肝脏CT扫描。随访1年,经CT确定肝癌复发。结果:治疗组Karnofsky评分有效率为59.26%,对照组Karnofsky评分有效率为37.03%,两组Karnofsky评分有效率相比较,差异有统计学意义(P<0.05)。两组治疗后症状变化相比较,除腹胀外其余各项指标差异均有统计学意义(P<0.05)。治疗后两组相比较,ALT和AFP差异有统计学意义(P<0.05)。治疗后两组T细胞亚群变化相比较,治疗组各项指标均变化显著(P<0.05)。治疗后随访一年,治疗组复发率为22.22%;对照组复发率为53.70%。两组治疗一年后复发率相比较,差异有统计学意义(P<0.05)。结论:化疗结合冷循环射频消融术治疗原发性肝癌疗效肯定,并发症及副作用小,复发率低。

Objective： To study and investigate the curative effect and security of chemotherapy combined with cool-tip radiofrequency ablation in treatment of primary liver cancer. Methods： 108 patients with primary liver cancer were randomly divided into two groups and both groups were given infusion chemotherapy one time every four weeks. The control group （n=54） was treated for 3 ti- mes, while the treatment group （n=54）was treated only for once. Treatment group was also given cool-tip radiofrequency ablation, we evaluated the quality of life by Kamofsky scores, and detected the patient＇s blood, urine, stool routine examination, liver and kidney function （including indexes like aspartate aminotransferase, alanine aminotransferase （ALT）, albumin （ALB）, total bilirubin and creatinine and urea nitrogen）, alpha fetoprotein （AFP） and T cell subsets, and strengthen liver CT scans before and after treatment. CT was used to determine liver cancer recurrence during the follow-up 1 year later. Results： The effective rate of Karnofsky score was 59.26% in treatment group, and was 37.03% in control group, with statistically significant difference （P〈0.05）. Except for abdominal distension, the other symptom indexes were changed in the two groups after treatment, and the differences was statistical significant （P〈0.05）. After treatment, the ALT and AFP also had statistically significant difference between two groups （P〈0.05）. In terms ofT cell subsets changes of two groups, all the indicators of treatment group changed more significantly （P〈0.05）. In the follow-up year after treatment, the recurrence rate of treatment group was 22.22%, and that of control group was 53.70%, having statistically significant difference （P〈0.05）. Conclusion： Chemotherapy combined with cool-tip radiofrequency ablation had determined curative effect on primary liver cancer, as well as less complications, less side effects and low recurrence rat.