经导管动脉栓塞化疗联合局部热消融治疗大肝癌的临床疗效及对患者肝功能和预后的影响

Clinical efficacy of transcatheter arterial chemoembolization combined local thermal ablation in the treatment of large liver cancer and its effect on liver function and prognosis

目的探讨经导管动脉栓塞化疗(TACE)联合局部热消融治疗大肝癌的临床疗效及对患者肝功能和预后的影响。方法根据治疗方案的不同将122例大肝癌患者分为观察组(n=62)和对照组(n=60),对照组患者接受常规TACE治疗,观察组患者接受TACE联合局部热消融治疗。比较两组患者的临床疗效、肝功能指标[丙氨酸转氨酶(ALT)、白蛋白(ALB)及总胆红素(TBIL)]、并发症发生情况及预后。结果观察组患者的疾病控制率为83.87%,高于对照组患者的68.33%,差异有统计学意义(P﹤0.05)。治疗后,两组患者的ALT、TBIL水平均低于本组治疗前,ALB水平均高于本组治疗前,观察组患者的ALT、TBIL水平均低于对照组,ALB水平高于对照组,差异均有统计学意义(P﹤0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P﹥0.05)。观察组患者的2年生存率为70.97%,高于对照组患者的53.33%,差异有统计学意义(P﹤0.05)。结论TACE联合局部热消融治疗大肝癌患者可控制疾病进展,改善患者肝功能,还能提高远期生存率,且安全性较高。

Objective To explore the clinical efficacy of transcatheter arterial chemoembolization(TACE)combined local thermal ablation in the treatment of large liver cancer and its effect on liver function and prognosis.Method A total of 122 patients with large liver cancer were divided into observation group[n=62,received TACE+local thermal ablation)and control group(n=60,received TACE).The clinical efficacy,liver function indexes[alanine aminotransferase(ALT),albumin(ALB)and total bilirubin(TBIL)],complications and prognosis were compared between the two groups.Result The disease control rate of the observation group was 83.87%,higher than 68.33%of the control group(P<0.05).After treatment,the levels of ALT and TBIL in the two groups were lower than those before treatment,the level of ALB were higher than those before treatment,with lower levels of ALT and TBIL and higher level of ALB in the observation group than those in the control group(P<0.05).There was no significant difference in the total incidence rate of complications between the two groups(P>0.05).The 2-year survival rate of the observation group was 70.97%,higher than 53.33%of the control group(P<0.05).Conclusion The combination of TACE and local thermal ablation can control disease progression,improve the liver function and the long-term survival rate,with higher safety in the treatment of large liver cancer.