不同治疗次数肝动脉化疗栓塞术对原发性肝癌患者肝功能及预后的影响

Effect of transcatheter arterial chemoembolization with different treatment times on liver function and prognosis in patients with hepatic cell cancer

目的探讨不同治疗次数肝动脉化疗栓塞(TACE)术对原发性肝癌(HCC)患者肝功能及预后的影响。方法回顾性分析2014年11月至2017年11月于本院行TACE术治疗的98例HCC患者的临床资料,按照治疗次数不同分为6组,3次组6例,4次组23例,5次组31例,6次组18例,7次组15例,8次组5例。比较各组末次治疗后1个月肝硬化CT形态分级和肝功能Child-Pugh分级,分析TACE治疗次数与肝硬化CT形态分级、肝功能Child-Pugh分级的相关性,比较各组末次治疗后3年生存率。结果随着TACE治疗次数增加,肝功能Child-Pugh分级、肝硬化CT形态分级逐渐升高,差异有统计学意义(P<0.05);TACE治疗次数与肝硬化CT形态分级、患者肝功能Child-Pugh分级呈正相关(r>0,P<0.05);经Log-rank检验显示,不同组别末次治疗后3年生存率比较差异无统计学意义。结论TACE治疗次数越多对患者肝功能的损害越大,且对预后改善无影响。

Objective To investigate the effect of transcatheter arterial chemoembolization(TACE)with different treatment times on liver function and prognosis in patients with hepatic cell cancer(HCC).Methods The clinical data of 98 patients with HCC who underwent TACE treatment in our hospital from November 2014 to November 2017 were retrospectively analyzed,they were divided into six groups according to the number of treatment times,6 cases in the three times group,23 cases in the four times group,31 cases in the five times group,18 cases in the six times group,15 cases in the seven times group,and 5 cases in the eight times group,the CT morphological grading and Child-Pugh grading of liver function in each group one month after the last treatment were compared,the correlation between the number of TACE treatments times and the CT morphological grading and Child-Pugh grading of liver function were analyzed,and the 3-year survival rate of each group after the last treatment were compared.Results As the number of TACE treatments increased,the Child-Pugh grading of liver function and CT morphological grading of liver cirrhosis gradually increased,the difference was statistically significant(P<0.05);the number of TACE treatments was positively correlated with the CT morphological grading and liver function Child-Pugh grading of liver cirrhosis(r>0,P<0.05);the Log-rank test showed that there was no statistically significant difference in 3-year survival rates among different groups after the last treatment.Conclusion With the increase of TACE treatment frequency,the damage to liver function is greater,and has no effect on the improvement of prognosis.