早中期原发性肝癌患者TACE术后早期死亡的相关因素分析

Analysis of related factors of early death after transcatheter arterial chemoembolization for patients with early- and middle-stage primary hepatocellular carcinoma

目的通过对早中期原发性肝癌患者经导管肝动脉化疗栓塞术(TACE)后早期死亡病例回顾性研究,分析患者术后早期死亡的相关因素。方法收集近5年早中期原发性肝癌TACE术后病例,术后30 d内死亡病例(26例)作为研究组,选取术后30 d内存活病例(50例)作为对照组。收集患者性别、年龄、既往TACE次数、术前肿瘤有无假包膜、肝硬化CT分级、术中碘油用量、是否超选择栓塞肿瘤供血动脉、肝癌动脉供血类型等8项资料。采用SPSS 19.0统计分析软件包将数据进行单因素分析,将有统计学差异的结果引入Logistic回归模型进行分析。结果单因素分析结果显示,既往TACE次数、术中碘油用量、是否超选择栓塞肿瘤供血动脉、肝癌动脉供血类型组间差异有统计学意义(P<0.05)。Logistic回归分析结果显示,肝癌动脉供血类型、既往TACE次数与早中期肝癌TACE术后早期死亡相关性较大(P<0.05)。结论肝癌动脉供血类型、既往TACE次数对早中期肝癌TACE术后短期死亡风险的影响较大。

Objective To retrospectively analyze the clinical data of patients diagnosed with early- and middle-stage primary hepatocellular carcinoma （HCC） with early death after transcatheter arterial chemo-embolization （TACE） and investigate the factors related to postoperative early death after TACE. Methods Clinical data of patients diagnosed with early- and middle-stage primary HCC undergoing TACE were collected in the recent 5 years. Twenty six patients who died within 30 d after TACE were allocated into the study group, and 50 cases who survived within postoperative 30 d were recruited as normal controls. Sex, age, frequency of previous TACE, the incidence of pseudocapsule tumor before TACE, CT classification of liver cirrhosis, intrao-perative quantity of lipiodol use, superselective embolization of tumor-feeding arteries and type of arterial blood supply were obtained. SPSS 19. 0 software package was used for univariate analysis. The factors with statistical significance were incorporated into the binary logistic regression analysis. Results Univariate analysis revealed that frequency of previous TACE, intraoperative quantity of lipiodol use, superselective embolization of tumor-feeding arteries and type of arterial blood supply significantly differed between the study and control groups （ all P 〈0. 05）. Binary logistic regression analysis demonstrated that type of arterial blood supply and frequency of previous TACE were correlated with early death after TACE （ both P 〈 0. 05 ） . Conclusion Type of arterial blood supply and frequency of previous TACE are significant influencing factors of early death after TACE in patients with early- and middle-stage primary HCC.