经导管动脉栓塞化疗治疗原发性肝癌的疗效及对患者预后的影响

Efficacy of transcatheter arterial chemoembolization in the treatment of primary liver cancer and its influence on the prognosis of patients

目的 探讨经导管动脉栓塞化疗(TACE)治疗原发性肝癌的疗效及对患者预后的影响。方法 依据治疗方式的不同将87例原发性肝癌患者分为对照组(n=41)和观察组(n=46),对照组患者给予经导管动脉灌注化疗(TAI),观察组患者给予TACE治疗。比较两组患者的近期疗效、肝功能指标[白蛋白、谷丙转氨酶(ALT)、总胆红素(TBIL)、甲胎蛋白(AFP)]、生活质量[卡氏功能状态(KPS)评分]和远期预后。结果 观察组患者的治疗总有效率为80.43%,高于对照组患者的58.54%(P﹤0.05)。治疗2个月后,观察组患者的肿瘤最大直径明显短于对照组(P﹤0.01)。治疗后,两组患者白蛋白、AFP水平均低于本组治疗前(P﹤0.05),ALT、TBIL水平均高于本组治疗前(P﹤0.05),且观察组患者白蛋白、AFP水平均低于对照组(P﹤0.05),ALT、TBIL水平均高于对照组(P﹤0.05)。治疗后1周、随访6个月,两组患者KPS评分均高于本组治疗前(P﹤0.05),且观察组患者KPS评分均高于对照组(P﹤0.05)。治疗1、2年,观察组患者的复发率均低于对照组(P﹤0.05)。结论 TACE治疗原发性肝癌患者的近期疗效显著,能有效改善患者肝功能指标、生活质量和预后。

Objective To investigate the efficacy of transcatheter arterial chemoembolization(TACE) in the treatment of primary liver cancer and its impact on the prognosis of patients. Method According to different treatment methods, 87 patients with primary liver cancer were divided into control group(n=41) and observation group(n=46). The control group was given transcatheter arterial infusion chemotherapy(TAI), and the observation group was given TACE treatment. The short-term efficacy, liver function index [albumin, alanine aminotransferase(ALT), total bilirubin(TBIL), α-fetal protein(AFP)], quality of life [Karnofsky performance status(KPS) score] and long-term prognosis were compared between the two groups. Result The total effective rate of the observation group was 80.43%, which was higher than58.54% of the control group(P<0.05). After 2 months of treatment, the maximum tumor diameter of the observation group was significantly shorter than that of the control group(P<0.01). After treatment, the levels of albumin and AFP in the two groups were lower than those before treatment(P<0.05), and the levels of ALT and TBIL were higher than those before treatment(P<0.05), and the levels of albumin and AFP in the observation group were lower than those in the control group(P<0.05), the levels of ALT and TBIL were higher than those in the control group(P<0.05). One week after treatment and 6 months of follow-up, the KPS scores of the two groups were higher than those before treatment(P<0.05),and the KPS scores of the observation group were higher than those of the control group(P<0.05). After 1 and 2 years of treatment, the recurrence rate of the observation group was lower than that of the control group(P<0.05). Conclusion The short-term efficacy of TACE in the treatment of patients with primary liver cancer is remarkable, and it can effectively improve the liver function indicators, quality of life and prognosis of patients.