不同治疗方式对原发性肝癌预后的影响及危险性因素分析

Effects of Different Treatments on the Prognosis of Primary Hepatocellular Carcinoma and Risk Factors Analysis

目的探讨不同治疗方式对原发性肝癌预后的影响以及肝癌术后生存期相关危险性因素的分析。方法选取我院收治的原发性肝癌患者71例,根据病情及患者意愿分别进行手术治疗、介入化疗以及姑息治疗。观察治疗后患者的并发症发生情况以及术后生存情况。结果手术组半年、1年、2年生存率分别为88%(36/41)、66%(27/41)、44%(18/41),介入组分别为80%(20/25)、52%(13/25)、8%(2/25);姑息组分别为100%(5/5)、80%(4/5)、0%(0/5)。三组患者的2年生存率比较,差异有统计学意义(P<0.05)。三组患者的主要并发症为低蛋白血症、胸腹腔积液,发生率无明显差异(P>0.05)。年龄、乙肝病毒感染史、饮酒史对三组患者2年生存率的影响比较,差异有统计学意义(P<0.05)。结论采用手术治疗的原发性肝癌患者长期生存率显著高于介入治疗,但结合长期经验,考虑手术联合化疗的治疗效果更好;年龄、饮酒史对原发性肝癌患者的生存率具有显著影响。

Objective To explore the effect of different treatment methods on the prognosis of primary liver cancer and analyze the risk factors related to the survival of patients with liver cancer after surgery.Methods Seventy-one patients with primary liver cancer in our hospital were treated with surgical treatment,interventional chemotherapy or conservative treatment according to the condition and patients'wishes.The complications and postoperative survival were observed after different treatments.Results The half-year,1-year and 2-year survival rate of the surgical treatment group was respectively 88%(36/41),66%(27/41)and 44%(18/41).That of the interventional chemotherapy group was respectively 80%(20/25),52%(13/25)and 8%(2/25).That of the conservative treatment group was respectively 100%(5/5),80%(4/5)and 0%(0/5).There was significant difference in the 2-year survival rate between the three groups(P<0.05).The main complications in the three groups included hypoproteinemia and pleural effusion,but no significant differences were found in their incidences between the groups(P>0.05).Age,HBV history and drinking history were observed to have a significant effect on the 2-year survival rate(P<0.05).Conclusion The long-term survival rate of primary liver cancer patients with surgical treatment was higher than that of patients with interventional chemotherapy.Surgery combined with intraoperative chemotherapy could be considered as a more effective treatment.Age and drinking history had significant effect on postoperative survival of primary liver cancer.