载药微球联合碘化油肝动脉化疗栓塞术序贯射频消融术治疗大肝癌的疗效观察

Efficacy of drug loaded microspheres combined with iodized oil transarterial chemoembolization and sequential radiofrequency ablation for large hepatocellular carcinoma

目的探讨载药微球联合碘化油肝动脉化疗栓塞术(TACE)序贯射频消融术治疗大肝癌的临床观察。方法选取2017年1月至2019年11月间盘锦市中心医院收治的100例大肝癌患者,根据治疗方式的不同进行分组。其中,采用碘化油TACE序贯射频消融术治疗的58例患者纳入对照组,采用载药微球联合碘化油TACE序贯射频消融术治疗的42例患者纳入观察组。观察两组患者的治疗效果,术后肝功能指标及不良反应差异。结果重复测量结果显示,观察组患者治疗有效率高于对照组,差异有统计学意义(P<0.05)。在不同时点下,两组患者治疗有效率差异显著,差异有统计意义(P<0.05)。术后两组患者肝功能指标比较,差异无统计学意义(P>0.05)。两组患者术后发热、恶心呕吐、腹痛腹胀、胸腔积液及肝脓肿等不良反应比较,差异均无统计学意义(P>0.05)。研究组患者生存率为81.0%,平均生存时间为(9.72±3.13)个月,均高于对照组患者的62.1%和(8.63±2.82)个月,差异有统计学意义(P<0.05)。结论载药微球联合碘化油TACE术序贯射频消融术治疗大肝癌疗效明显,安全性较高,不增加肝脏毒性与不良反应,且利于患者的预后生存。

Objective To explore the clinical efficacy of drug loaded microspheres combined with iodized oil transarterial chemoembolization(TACE)sequential radiofrequency ablation for the treatment of large hepatocellular carcinoma.Methods A total of 100 patients with large liver cancer admitted to Panjin Central Hospital from January 2017 to November 2019 were selected.According to the differences in the treatment methods,they were divided into an observation group and a control group.Of them,42 patients receiving drug loaded microbeads combined with TACE using iodized oil and sequential radiofrequency ablation group were included in an observation group and 58 patients receiving TACE using iodized oil and sequential radiofrequency ablation group were included in a control group.The therapeutic efficacy,postoperative liver function indices and adverse reactions were compared between the two groups.Results The repeated measurement results showed that the efficacy rate was significantly higher in the observation group than in the control group(P<0.05).Moreover,there was significant difference in the efficacy rate at different time points(all P<0.05).There was no statistically significant difference in liver function indices including hemoglobin,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and albumin between the two groups after operation(P>0.05).There was no statistically significant difference in postoperative adverse reactions such as fever,nausea and vomiting,abdominal pain and abdominal distension,pleural effusion and liver abscess between the two groups(P>0.05).The survival rate was 81.0%in the observation group with the average survival period of 9.72±3.13 months.The survival rate was 62.07%in the control group with the average survival time period of 8.63±2.82 months(P<0.05).Conclusion Drug-loaded microspheres plus TACE using iodized oil and sequential radiofrequency ablation showed significant efficacy for the treatment of large hepatocellular carcinoma with high safety without increasing hepatotoxicity and adverse reactions,and it is beneficial to the prognosis and survival of patients.