经导管肝动脉化疗栓塞联合抗病毒治疗肝细胞癌的疗效及对患者生存率的影响

Efficacy of transcatheter arterial chemoembolization combined with antiviral therapy on hepatocellular carcinoma and its effect on Child-Pugh score and survival rate

目的探讨经导管肝动脉化疗栓塞联合抗病毒治疗肝细胞癌的疗效及其对Child—Pugh评分与患者生存率的影响。方法选取符合研究标准的72例肝细胞癌患者，根据治疗方案不同分为研究组与对照纽，每组36例。对照组仅行肝动脉化疗栓塞术，研究组在肝动脉化疗栓塞术基础上实施抗病毒治疗。统计两组临床疗效及不同随访时间（第3、6、12个月）生存率，并对比治疗前及治疗后不同时间两组Child—Pugh评分变化情况。结果研究组稳定率（86．11％）及有效率（44．44％）与对照组（83．33％、38．88％）对比，差异均未见统计学意义（P〉0．05）；治疗前及治疗后3个月时两组Child-Pugh评分对比，差异未见统计学意义（P〉0．05），治疗6、12个月时研究组Child—Pugh评分明显优于对照组，差异有统计学意义（P〈0．05）；治疗后第3、6个月时研究组生存率（77．78％、63．89％）与对照组（80．56％、55．56％）对比，差异未见统计学意义（P〉0．05），第12个月时研究组生存率（44．44％）明显高于对照组（22．22％），差异有统计学意义（P〈0．05）。结论在经导管肝动脉化疗栓塞治疗基础上对肝细胞癌患者实施抗病毒治疗效果显著，可有效抑制乙肝病毒复制，改善患者肝功能，提高远期生存率，具有推广价值。

Objective To investigate the effect of transcatheter arterial chemoembolization combined with antiviral therapy on hepatocellular carcinoma and its effect on Child-Pugh score and survival rate of patients with hepatocellular carcinoma. Methods Seventy-two cases of hepatocellular carcinoma were selected from January 2014 to May 2015. According to the different treatment options, they were di- vided into study group and control group, with 36 cases in each group. The control group was only treated with transcatheter arterial chemoembolization, and the study group was treated with anti viral therapy on the basis of hepatic artery chemoembolization. The clinical efficacy and different follow-up times （the third, 6, 12 months） survival rates, and the Child-Pugh score changes before and after treatment were compared. Results The stabihty of the study group （86. 11% ） and the effective rate （44.44%） compared with the control group （83.33%, 38.88% ）, the differences were not significant （P 〉0. 05 ） ; Before treatment and after treatment for 3 months of two groups of Child-Pugh score comparison, the difference was not significant （P 〉0.05）, 6 and 12 months of treatment, the Child -Pugh scores were significantly better than those of the control group, the difference were significant （ P 〈 0. 05 ） ; At the 3, 6 months after treatment, the survival rates of the study group （77.78% , 63.89% ） compared with the control group （80.56%, 55.56% ）, the differences were not significant （P 〉 0.05 ）. The survival rate （44.44%） in the study group was significantly higher than that in the control group （22. 22% ） at the twelfth months, and the difference was significant （P 〈 0.05）. Conclusions In the transcatheter arterial chemoembolization therapy in patients with hepatocellular carcinoma （ HCC ） implementation of the antiviral treatment effect is remarkable, can effectively inhibit hepatitis B virus replication, improve the liver function of patients and improve the long-term survival rate and has the value of popularization.