化疗栓塞治疗原发性肝癌合并肝动静脉瘘的临床效果

Clinical Effect of Chemoembolization in the Treatment of Primary Liver Cancer with Hepatic Arteriovenous Shunts

目的探讨经导管动脉内化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌合并肝动静脉瘘(hepatic arteriovenous shunts,HAVS)的临床疗效。方法选取原发性肝癌合并HAVS患者150例,按随机数字表法分为观察组和对照组,各75例。观察组给予先堵瘘后进行TACE治疗,对照组先给予TACE治疗后堵瘘,比较其堵瘘程度、疗效、不良反应及预后情况。结果治疗后观察组完全封堵38例,部分封堵30例,无变化7例;对照组完全封堵23例,部分封堵30例,无变化22例,观察组患者堵瘘情况优于对照组,差异有统计学意义(P<0.01)。观察组完全缓解12例,部分缓解35例,总有效率为62.67%;对照组完全缓解4例,部分缓解21例,总有效率为33.33%,观察组总有效率高于对照组,差异有统计学意义(P<0.01)。观察组共发生不良反应11例(14.67%),对照组17例(22.67%),2组不良反应发生率差异无统计学意义(P>0.05)。观察组1 a生存率为61.33%(46/75),对照组为33.33%(25/75),观察组生存率高于对照组,差异有统计学意义(P<0.01)。结论TACE治疗原发性肝癌合并HAVS疗效较好。

Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer with hepatic arteriovenous shunts(HAVS).Methods A total of 150 patients with primary hepatic carcinoma and HAVS were enrolled.The patients were divided into observation group and control group by random number table(75 cases in each group).The observation group was given TACE treatment after first blocking the sputum,and the control group was given the first TACE treatment after blocking the sputum,comparing the degree of phlegm,efficacy,adverse reaction and prognosis.Results After treatment,the observation group was completely blocked in 38 cases,and 30 cases were mostly blocked,7 cases were unchanged,23 cases were completely blocked in the control group,30 cases were blocked in the majority,and 22 cases were unchanged.The obstruction condition of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).The observation group had complete remission in 12 cases and partial remission in 35 cases,the total effective rate was 62.67%.In the control group,4 cases were completely relieved and 21 cases were partially relieved,the total effective rate was 33.33%.The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.01).There were 11 cases(14.67%)with adverse reactions in the observation group and 17 cases(22.67%)in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The survival rate of the observation group was 61.33%(46/75)in the observation group and 33.33%(25/75)in the control group.The survival rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.01).Conclusion TACE is effective in the treatment of primary liver cancer with HAVS.