腹腔镜肝切除术后预防性TACE联合软坚消瘤汤治疗肝癌的中远期疗效评价

Clinical Observation of Prophylactic TACE Combined with Ruanjian Xiaoliu Decoction in the Treatment of Liver Cancer after Laparoscopic Hepatectomy

目的探讨腹腔镜肝切除术后预防性肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合软坚消瘤汤治疗肝癌患者的中远期疗效。方法选择于本院就诊的原发性肝癌患者98例,根据自然条件、肿瘤大小及部位等因素将其分为治疗组(49例)和对照组(49例)。对照组予以腹腔镜肝切除术及术后TACE加常规治疗,在此基础上,治疗组联合软坚消瘤汤治疗。比较2组肝功能、甲胎蛋白(AFP)等生化指标,术后并发症的发生及中医证候积分和Karnofsky功能状态评分(KPS)变化,对2组患者进行动态连续远期随访并绘制生存曲线。结果治疗后,治疗组AFP、AST、ALT等生化指标均明显优于对照组(P<0.05);治疗组中医证候积分显著降低(P<0.05),KPS评分显著提高(P<0.05);治疗组术后并发症发生率显著低于对照组(P<0.05);2组患者生存率比较,差异无统计学意义(P>0.05)。结论腹腔镜肝切除术后预防性TACE联合软坚消瘤汤可有效改善肝癌患者临床症状,提高生存质量,并减少并发症的发生。

Objective To study the medium and long term curative effects of prophylactic transcatheter arterial chemoembolization(TACE)combined with Ruanjian Xiaoliu decoction in the treatment of liver cancer after laparoscopic hepatectomy.Methods A total of 98 patients with primary liver cancer were selected and divided into treatment group(n=49)and control group(n=49)according to the natural conditions,tumor size and location.The control group was treated with laparoscopic hepatectomy and postoperative TACE plus routine treatment.The treatment group was treated with Ruanjian Xiaoliu decoction on the basis of the control group.The biochemical indexes such as liver function and alpha fetoprotein(AFP)were compared in both groups.The occurrence of postoperative complications and the changes of TCM and KPS scores were compared in the two groups.A dynamic continuous long-term follow-up was performed for both groups and a survival curve was plotted.Results After treatment,the biochemical indexes such as AFP,AST,ALT in the treatment group were significantly better than those in the control group(P<0.05).The scores of TCM syndromes in the treatment group were significantly lower than those in the control group(P<0.05),and the KPS scores in the treatment group were significantly higher than those in the control group(P<0.05).The incidence of postoperative complications in the treatment group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the survival rate between the two groups(P>0.05).Conclusion Prophylactic TACE combined with Ruanjian Xiaoliu decoction after laparoscopic hepatectomy can effectively improve the clinical symptoms and the quality of life and reduce the occurrence of complications of patients with liver cancer.