320排CT支持下肝癌介入治疗的临床观察

Clinical observation on interventional therapy of liver cancer with support of 320-row CT

目的观察320排CT支持下经导管肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PLC)的近期疗效。方法回顾性分析我院收治的125例行TACE治疗的PLC患者,研究组65例患者术前先行320排CT检查,观察肿瘤影像表现及其供瘤动脉的起源走行和变异情况,并通过血管重建模型上的模拟训练,拟定插管及栓塞方案后行TACE;对照组60例经16排CT检查观察肿瘤影像表现后行TACE;术后1个月分析并比较两组患者的近期疗效和不良反应。结果研究组治疗的有效率为64.6%高于对照组的46.7%(P<0.05),而不良反应发生率低于对照组(P<0.05);两组治疗后血清AFP、TNF-α、VEGF和CD8+T细胞水平均明显减低,而CD4+T细胞及卡洛夫斯基功能状态(KPS)评分明显增高(P<0.05),组间比较研究组改变更明显(P<0.05)。结论 320排CT可快速准确地评估PLC肿瘤及供血情况,在其支持下的TACE治疗可明显提高疗效及减轻不良反应。

Objective To observe the short-term therapeutical effect of transcatherter arterial chemoembolization （TACE） with support of 320-row CT on primary liver cancer （ PLC）. Methods A total of 125 PLC patients, who had been treated with TACE, were retrospectively analyzed. Trial group （ n = 65 ） underwent 320-row CT examination before surgery for observation of tumor imaging performance, origination and arterial heteromorphosis situation. Besides, simulated training was rebuih on models through blood vessel. TACE was conducted after planning a catheterization and embolization regime. Control group （ n = 60） underwent TACE af- ter 16-row CT examination. The short-term therapeutical effects and adverse reactions after one month were analyzed and compared between the two groups. Results The overall response rate （64.6%） of the trial group was higher than that （46.7%） of the control group （P 〈 0.05） , and adverse reaction rate was lower in the trial group than in the control group （ P 〈 0.05 ）. Serum alpha fetal protein （AFP）, tumor necrosis factor-α（TNF-α）, vascular endothelial growth factor （VEGF） and CD8 ＋ T were obviously decreased and serum cell CD4 ＋ T and KPS were obviously increased in both the two groups （ P 〈 0.05 ） , but the more obvious changes were found in the trial group （P 〈 0.05）. Conclusion It is suggested that 320-row CT helps to evaluate the tumor condition and blood-supply quickly and correctly in PLC. With its support, TACE treatment can obviously increase the curative effect and decrease the adverse reaction as well.