肝动脉化疗栓塞术联合经皮射频消融术治疗中晚期肝癌的临床疗效评价

Evaluation of clinical efficacy of transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in the treatment of patients with advanced liver cancer

目的:观察肝动脉化疗栓塞术联合经皮射频消融术治疗中晚期肝癌患者的临床治疗效果。方法:将83例中晚期肝癌患者按照就诊顺序随机分为对照组和观察组,对照组47例,观察组36例。对照组给予肝动脉化疗栓塞治疗,观察组给予肝动脉化疗栓塞术联合经皮射频消融治疗,治疗后观察患者血清甲胎蛋白水平变化,肿瘤大小、生存情况及不良反应。结果:治疗后,两组患者血清甲胎蛋白水平均有下降,对照组患者下降率为55.32%,观察组患者为80.56%,两组患者血清甲胎蛋白水平下降率相比较,差异有统计学意义(P<0.05);观察组患者中位生存时间为22.4个月,1年累积生存率为79.4%,临床治疗总有效率为77.78%;对照组中位生存时间为14.8个月,1年累积生存率为57.8%,临床治疗总有效率为57.44%;两组患者1年累积生存率、临床治疗总有效率相比较,差异均有统计学意义(P<0.05);威胁生命不良事件方面,对照组3例,观察组2例;观察组血小板下降总不良反应发生率为72.22%,与对照组的78.72%相比较,差异有统计学意义(P<0.05)。结论:肝动脉化疗栓塞术联合经皮射频消融术治疗中晚期肝癌患者临床效果明显,能够有效降低患者血清甲胎蛋白含量,提高患者生存时间,未见严重不良反应发生。

Objective To observe the clinical therapeutic effect of transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation on patients with advanced liver cancer.Method 83 patients with advanced liver cancer were randomly divided into the control group and the observation group according to the order of treatment,47 cases in the control group and 36 cases in the observation group.The control group was given hepatic arterial chemoembolization,and the observation group was given hepatic arterial chemoembolization combined with percutaneous radiofrequency ablation.After treatment,the patients′serum alpha-fetoprotein content changes,tumor size,survival status,and adverse reactions were observed.Results After treatment,the levels of serum alpha-fetoprotein in both groups decreased.The rate of decline in the control group was 55.32%and that in the observation group was 80.56%.The difference in serum alpha-fetoprotein levels between the two groups was statistically significant(P<0.05);The median survival time of the observation group was 22.4 months,the 1-year cumulative survival rate was 79.4%,and the total effective rate of clinical treatment in the observation group was 77.78%;The median survival time of the control group was 14.8 months,the 1-year cumulative survival rate was 57.8%,and the total effective rate of clinical treatment was 57.44%;The 1-year cumulative survival rate and total clinical effective rate of the two groups of patients were statistically significant(P<0.05);There were 3 cases of life-threatening adverse events in the control group and 2 cases in the observation group;The total adverse reaction rate of platelet decline in the observation group was 72.22%,compared with 78.72%in the control group,the difference was statistically significant(P<0.05).Conclusion Transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation has obvious clinical effect in the treatment of patients with advanced liver cancer.It can effectively reduce the serum alpha-fetoprotein content of patients and improve the survival time of patients.