三氧化二砷经导管肝动脉化疗栓塞介入治疗中晚期原发性肝癌临床疗效及安全性观察

Clinical efficacy and safety of arsenic trioxide in interventional treatment of advanced primary liver cancer with transcatheter hepatic arterial chemoembolization

目的研究中晚期原发性肝癌治疗中三氧化二砷经导管肝动脉化疗栓塞介入疗法的应用效果。方法采用回顾性分析方法,研究对象为2017年1月至2018年6月武警山东省总队医院收治的82例中晚期原发性肝癌患者,根据治疗方式不同将其分为研究组(n=41)与对照组(n=41),对照组选用常规肝动脉栓塞疗法,研究组选用三氧化二砷经导管肝动脉化疗栓塞介入疗法。比较2组治疗后总有效率、生存率及不良反应[心电图T波及ST-T改变、胆红素异常、白蛋白降低、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)升高、AST升高]发生率。结果研究组治疗后总有效率为75.61%,明显高于对照组的53.66%,差异有统计学意义(P<0.05)。治疗后,研究组患者1年生存率为82.93%,明显高于对照组的60.98%,差异有统计学意义(P<0.05);2组患者2年生存率比较(46.34%vs.34.15%),差异无统计学意义(P>0.05)。研究组患者治疗后心电图T波及ST-T改变、胆红素异常、白蛋白降低、ALT升高、AST升高发生率分别为2.44%、4.88%、4.88%、7.32%、7.32%,明显低于对照组(17.07%、24.39%、21.95%、24.39%、26.83%),差异有统计学意义(P<0.05)。结论中晚期原发性肝癌治疗中三氧化二砷经导管肝动脉化疗栓塞介入疗法的应用效果显著,可延长患者生存周期,且不良反应少,安全性高。

Objective To study the application effect of arsenic trioxide transcatheter hepatic arterial chemoembolization interventional therapy in the treatment of advanced primary liver cancer.Methods Using a retrospective analysis method,the study object was 82 patients with intermediate and advanced primary liver cancer admitted to the Shandong Provincial General Hospital of the Armed Police Force from January 2017 to June 2018.According to different treatment methods,they were divided into study group(n=41)and control group(n=41),the control group used conventional hepatic artery embolization therapy,and the study group used arsenic trioxide transcatheter hepatic artery chemoembolization interventional therapy.The total effective rate,survival rate and incidence of adverse reactions[ECG T wave and ST-T changes,abnormal bilirubin,decreased albumin,alanine transaminase(ALT)increase,aspartic transaminase(AST)increase]were compared between the two groups after treatment.Results The total effective rate of the study group after treatment was 75.61%,which was significantly higher than the control group's 53.66%,the difference was statistically significant(P<0.05).After treatment,the 1-year survival rate of patients in the study group was 82.93%,which was significantly higher than 60.98%in the control group,the difference was statistically significant(P<0.05);Comparison of the 2-year survival rate between the two groups(46.34%vs.34.15%),the difference was not statistically significant(P>0.05).After treatment,the incidence of changes in ECG T-swept ST-T,abnormal bilirubin,albumin reduction,ALT increase,and AST increase were 2.44%,4.88%,4.88%,7.32%,and 7.32%,respectively,in the study group,which were significantly lower In the control group(17.07%,24.39%,21.95%,24.39%,26.83%),the differences were statistically significant(P<0.05).Conclusion In the treatment of advanced primary liver cancer,the interventional therapy of transcranial hepatic artery chemoembolization with arsenic trioxide is effective,can prolong the life cycle of patients,and has fewer adverse reactions and high safety.