肝动脉化疗栓塞术治疗原发性肝癌患者的效果分析

Effect analysis of transcatheter arterial chemoembolization on patients with primary liver cancer

目的探讨原发性肝癌患者应用肝动脉化疗栓塞术治疗的效果。方法88例原发性肝癌患者,使用随机数字表法分为观察组及对照组,每组44例。对照组予以肝动脉灌注化疗,观察组实施肝动脉化疗栓塞术治疗。比较两组患者手术治疗后1、2年内的复发情况;术后并发症发生情况;生活质量;治疗前后肝功能[丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、门冬氨酸氨基转移酶(AST)、乙型肝炎(乙肝)病毒脱氧核糖核酸(HBV-DNA)]水平。结果两组手术治疗后1、2年内的复发率比较,观察组略低于对照组,但差异不具备统计学意义(P>0.05)。与对照组的18.18%比较,观察组术后并发症发生率4.55%显著较低,差异显著(P<0.05)。治疗后,两组社会功能、躯体功能、物质生活、心理功能评分均升高,且观察组的社会功能评分(86.06±5.75)分、躯体功能评分(82.75±4.09)分、物质生活评分(81.64±5.43)分、心理功能评分(80.70±5.88)分均高于对照组的(72.42±6.91)、(69.06±6.97)、(68.76±6.75)、(68.86±6.48)分,差异显著(P<0.05)。治疗后,两组患者ALT、TBIL、AST、HBV-DNA水平均下降,且观察组ALT(46.66±10.25)U/L、TBIL(17.55±2.74)μmol/L、AST(30.50±3.55)U/L、HBV-DNA(0.92±0.51)×10^(3)copies/ml均低于对照组的(57.68±10.44)U/L、(20.65±2.37)μmol/L、(36.72±3.11)U/L、(2.82±0.71)×10^(3)copies/ml,差异显著(P<0.05)。结论原发性肝癌患者应用肝动脉化疗栓塞术治疗的临床效果显著,虽然术后2年内复发率和肝动脉灌注化疗差异不大,但是可减少术后并发症发生率,利于患者生活质量和肝功能的改善,建议临床推广应用。

Objective To explore the effect of transcatheter arterial chemoembolization on patients with primary liver cancer.Methods 88 cases of primary liver cancer were divided into an observation group and a control group using random number table method,with 44 cases in each group.The control group received hepatic artery infusion chemotherapy,and the observation group received transcatheter arterial chemoembolization.Patients in both groups were compared in terms of recurrence within 1 and 2 years after surgery,occurrence of postoperative complications,quality of life,liver function[alanine aminotrasferase(ALT),total bilirubin(TBIL),aspartate transaminase(AST)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)]levels before and after treatment.Results The recurrence rate within 1 and 2 years after surgery in the observation group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Compared with 18.18%in the control group,the incidence of postoperative complications in the observation group was significantly lower at 4.55%,and the difference was significant(P<0.05).After treatment,the scores of social function,physical function,material life and psychological function increased in both groups;in the observation group,the social function score was(86.06±5.75)points,the physical function score was(82.75±4.09)points,the material life score was(81.64±5.43)points and the psychological function score was(80.70±5.88)points,which were higher than(72.42±6.91),(69.06±6.97),(68.76±6.75)and(68.86±6.48)points in the control group;the difference was significant(P<0.05).After treatment,the levels of ALT,TBIL,AST and HBV-DNA decreased in both groups;the observation group had ALT of(46.66±10.25)U/L,TBIL of(17.55±2.74)μmol/L,AST of(30.50±3.55)U/L,and HBV-DNA of(0.92±0.51)×10^(3) copies/ml,which were lower than(57.68±10.44)U/L,(20.65±2.37)μmol/L,(36.72±3.11)U/L,and(2.82±0.71)×10^(3) copies/ml in the control group;the difference was significant(P<0.05).Conclusion Transcatheter arterial chemoembolization has significant clinical effects in the treatment of primary liver cancer patients.Although the recurrence rate within 2 years after surgery is not significantly different from that of hepatic artery infusion chemotherapy,it can reduce the incidence of postoperative complications and is conducive to the improvement of patients'quality of life and liver function,so it is recommended to promote clinical application.