“双夹心法”碳酸氢钠联合TACE治疗巨块型肝癌研究

TACE combined with“double sandwich method”infusion of sodium bicarbonate for the treatment of massive hepatocellular carcinoma

目的探讨“双夹心法”碳酸氢钠联合TACE在巨块型肝癌中的应用价值。方法按照标准纳入60例巨块型肝癌患者进行临床研究,采取TACE治疗30例为对照组,“双夹心法”碳酸氢钠联合TACE治疗30例为研究组,均行每月1次共3个周期TACE治疗,期间动态评估疗效、生存质量、不良反应及血气pH值。结果虽然对照组疾病稳定率(SD)好于研究组(P<0.05),但研究组治疗后客观缓解率(ORR)、部分缓解率(PR)、甲胎蛋白(AFP)下降幅度、KPS评分均好于对照组(P<0.05),且肝功能损伤及临床不良反应两组差异无统计学意义(P>0.05)。研究组治疗后血气PH值较对照组升高,但均在正常可控范围内,未对患者预后带来不良影响。结论“双夹心法”碳酸氢钠联合TACE在巨块型肝癌治疗中疗效良好,无严重不良反应,可作为临床治疗方法之一。

Objective To discuss the clinical application value of transcatheter arterial chemoembolization(TACE)combined with“double sandwich method”infusion of sodium bicarbonate in treating massive hepatocellular carcinoma.Methods A total of 60 patients with massive hepatocellular carcinoma were included in this study.The patients were divided into the control group(n=30,treated with conventional TACE)and the study group(n=30,treated with TACE combined with“double sandwich method”infusion of sodium bicarbonate).The therapeutic programme was as follows:TACE was carried out once monthly lasting for 3 months.During the treatment period,the curative effect,the quality of life,the toxic side effects and the blood gas PH value were dynamically evaluated.Results All the objective response rate(ORR),partial remission rate(PRR),reduction extent of alphafetoprotein(AFP)level and Karnofsky Performance Status(KPS)score in the study group were significantly better than those in the control group(P<0.05),although the stable disease rate(SDR)in the control group was remarkably higher than that in the study group(P<0.05).No statistically significant differences in liver function injury and clinical adverse reactions existed between the two groups(P>0.05).After treatment,the blood gas PH value in the study group was higher than that in the control group,but in both groups it was within the normal controllable range and had no adverse effect on the prognosis of the patients.Conclusion For the treatment of massive hepatocellular carcinoma,TACE combined with“double sandwich method”infusion of sodium bicarbonate has satisfactory curative effect with no severe adverse reactions,therefore,it can be regarded as a reference method in clinical practice.(J Intervent Radiol,2021,31:83-87)