TACE联合外科手术治疗原发性肝癌32例临床研究

TACE combined with surgical operation in treatment of hepatocellular carcinoma:A clinical study of 32 cases

目的探讨TACE联合外科手术治疗原发性肝癌的疗效。方法选取2010年6月~2011年6月间于我院治疗的原发性肝癌患者60例,将60例原发性肝癌患者中应用TACE和外科手术治疗的32例患者设立为观察组,将其余28例单纯行外科手术治疗的患者设立为对照组,对照组采取常温下间歇阻断肝门肝切除法。观察组患者术后1个月同时行TACE术,TACE采用Seldingers法,比较两组的疗效,两组患者的肿瘤局部复发率、远处转移率及3年生存率、术后并发症情况。结果治疗后,观察组的临床总有效率为71.9%,对照组的临床总有效率为57.1%,两组疗效比较,差异存在统计学意义（χ^2=6.237,P〈0.05）。观察组的局部复发率、远处转移率、3年生存率与对照组分别比较,差异存在统计学意义（P〈0.05）。观察组并发症的发生率为18.75%,对照组并发症的发生率14.29%,两组并发症发生率比较,差异无统计学意义（P〉0.05）。结论 TACE联合外科手术治疗原发性肝癌取得了较好疗效,安全性好,且可以明显降低复发率、提高患者的生存率。

Objective To explore the curative effect of TACE combined with surgical operation in treatment of primary liver cancer. Methods From June 2010 to June 2011 in our hospital,selected 60 cases of primary liver cancer patients,32 cases of them were treated with TACE in patients with primary liver carcinoma and surgical operation in patients with established as the observation group, 28 cases were treated with the surgical operation treatment in patients with the establishment of the control group,the control group used normal temperature, adopt intermittent blocking hepatic portal hepatic cutting division. Patients in the observation group after 1 months and underwent TACE operation,the TACE used the Seldingers method, the clinical effects of two groups and local recurrence were compared between two groups in the rate of tumor, distant metastasis rate and survival rate in 3 years, the complications after operation were compared. Results After treatment, the clinical total effective rate of observation group was 71.9%, the clinical total effectiveness of control group was 57.1%, there were significant differences（χ^2=6.237,P〈0.05）. The local recurrence rate, the rate of distant metastasis, 3 years survival rate of the observation group were compared with the control group, there were significant differences between two groups（P〈0.05）. The incidence of complications of observation group was 18.75%, the control group was 14.29%,complications rate had no significant difference（P〉0.05）. Conclusion TACE combined with surgical operation in treatment of primary hepatocellular carcinoma has good curative effect,good security, and significantly reduce the recurrence rate, increase the survival rate of patients.