肝癌经导管动脉化疗栓塞术后发生栓塞综合征的影响因素

Influencing factor of post embolization syndrom after transcatheter arterial chemoembolization for liver cancer

目的探讨肝癌经导管动脉化疗栓塞术(TACE)后发生栓塞综合征(PES)的影响因素。方法将148例经TACE治疗的肝癌患者按是否发生PES分为PES组和NPES组,每组74例。对比两组患者的一般资料,分析PES发生的危险因素。结果NPES组与PES组患者性别、微球种类、微球个数、术前美国东部肿瘤协作组(ECOG)体力状况(PS)评分、巴塞罗那临床肝癌(BCLC)分期比较,差异均有统计学意义(P﹤0.05)。多因素分析显示,女性、术前ECOG PS评分较高、BCLC分期偏高、术中应用载药微球、微球个数较多均为肝癌患者TACE术后发生PES的危险因素(P﹤0.05)。结论女性、术前ECOG PS评分较高、微球种类为载药微球、微球个数较多、BCLC分期偏高均为肝癌患者TACE术后发生PES的危险因素,应于围手术期对具备上述危险因素的患者给予针对性干预,以提高介入治疗的安全性与患者预后。

Objective To investigate the influencing factors of post embolization syndrom(PES)after transcatheter arterial chemoembolization(TACE)for liver cancer.Method A total of 148 liver cancer patients treated with TACE were divided into PES group and NPES group according to whether PES occurred,with 74 cases in each group.The general data of the two groups of patients were compared,and the risk factors of PES were also analyzed.Result There were statistically significant differences in gender,microsphere type,number of microspheres,preoperative Eastern Cooperative Oncology Group(ECOG)performance status(PS)score,and Barcelona clinic liver cancer(BCLC)stage between the NPES group and the PES group(P<0.05).Multivariate analysis showed that female,higher preoperative ECOG PS score,higher BCLC stage,intraoperative application of drug-loaded microspheres,and more microspheres were risk factors for PES after TACE in patients with liver cancer(P<0.05).Conclusion Female,higher preoperative ECOG PS score,drug-loaded microspheres,more microspheres,and higher BCLC stage were all risk factors for PES in patients with liver cancer after TACE.Targeted intervention should be given to patients with the foregoing risk factors during the perioperative period to improve the safety of interventional therapy and prognosis of patients.