原发性肝细胞癌合并癌性腹水的综合治疗

Combined treatment to primary hepatocellular carcinoma complicated with carcinomatous ascites

目的 :探讨原发性肝细胞癌合并癌性腹水的综合治疗方案。方法 :将 5 6例肝癌合并腹水患者随机分为两组 :腹腔化疗 ,加生物治疗配合肝动脉化疗栓塞患者 2 8例为观察组 ;单纯肝动脉化疗栓塞患者 2 8例为对照组。结果 :观察组首次治疗 1月后控制腹水的有效率和 1年、2年的生存率分别为 85 .7% (2 4 / 2 8)、5 7.1% (16 / 2 8)、2 8.6 % (8/ 2 8)、而对照组分别为 5 7.1% (16 / 2 8)、2 8.6 % (8/ 2 8)、7.1% (2 / 2 8) ,两组比较有显著性差异 (χ2 值分别为 5 .6 0、4 .6 7、4 .38,P <0 .0 5 )。结论 :腹腔穿刺放净腹水 ,卡铂针剂腹腔内注射 ,补充人血白蛋白 ,加生物治疗配合肝动脉化疗栓塞是肝癌合并腹水有效的综合治疗方案。

Objective:To explore combined treatment to primary hepatocellular carcinoma(hepatic cancer) complicated with carcinomatous ascites(ascites).Methods:Dievided 56 cases of hepatic cancer complicated with ascites into 2 groups at random. 28 cases who had received abdominal chemotherapy adding biotherapy combined with hepatic artery chemotherapy embolization were set up as observing group.28 cases received hepatic artery chemotherapy embolization simply as control group.Results:After month's first round treatment,the effective rates of ascites control and survival rates after 1 year and 2 years of the cases in observing group were 85.7%(24/28),57 1%(16/28) and 28.6%(8/28) respectively.While the rates of the cases in control group were 57.1%(16/28),28.6%(8/28) and 7 1%(2/28) respectively.There were apparent differences between 2 groups(χ 2 value were 5.60,4.67 and 4.38 respectively,P<0 05).Conclusion:To discharge clearly the ascites fluid doing intraperitonial injecting with carboplatin injection and supplementing human serum,adding biotherapy combined with hepatic chemotherapy emboliaztion is an effective scheme of combined treatment to hepatic cancer complicated with ascites.