论文部分内容阅读
目的探讨经肝动脉化疗栓塞(TACE)联合选择性门静脉栓塞(SPVE)治疗在肝癌二期切除术中的临床应用效果和意义。方法选取2009年1月至2011年12月收治的不宜一期手术切除的中晚期肝癌患者86例,根据术式的不同将其分为研究组和对照组,每组43例。研究组肝癌患者采用TACE+SPVE+二期手术切除的联合治疗方案,对照组肝癌患者则仅采用SPVE+二期手术切除的联合治疗方案,分别对两组患者肝功能指标变化情况、肝脏体积变化情况、二期手术切除情况、生存率变化情况进行比较和分析。结果与对照组相比,研究组治疗后7 d的肝功能指标天冬氨酸氨基转移酶、丙氨酸氨基转移酶、总胆红素、凝血酶原时间均显著降低,差异均具有统计学意义(P均<0.01);研究组治疗后3周的右肝体积明显缩小,左肝体积明显增大,肝切除的体积/肝总体积的比率显著降低,两组间比较差异均具有统计学意义(P均<0.05);研究组行肝癌二期手术切除的比率显著提高,差异具有统计学意义(P<0.01);研究组患者的1、2、3年生存率均显著提高,差异均具有统计学意义(P<0.01)。结论TACE联合SPVE治疗能够进一步扩大中晚期肝癌肝切除手术的适应证,提高肝癌的切除率,延长肝癌患者的生存周期,为理想的手术方案。
Objective To investigate the clinical effect and significance of transcatheter arterial chemoembolization (TACE) and selective portal vein embolization (SPVE) in the second phase resection of liver cancer. Methods A total of 86 patients with advanced hepatocellular carcinoma (HCC) who were not eligible for primary surgery from January 2009 to December 2011 were selected and divided into study group and control group according to different surgical procedures, with 43 cases in each group. The study group of patients with hepatocellular carcinoma using TACE + SPVE + two surgical resection of the combined treatment of patients with liver cancer control group only with SPVE + two surgical resection combined treatment of liver function were changed in two groups of patients, liver volume changes, Two cases of surgical resection, the survival rate changes were compared and analyzed. Results Compared with the control group, the indexes of hepatic function such as aspartate aminotransferase, alanine aminotransferase, total bilirubin and prothrombin in study group were significantly decreased on the 7th day after treatment, the differences were statistically significant (P <0.01). After 3 weeks of treatment, the volume of the right hepatic tissue in the study group was significantly reduced, the volume of the left hepatic tissue was significantly increased, and the ratio of the volume of the hepatectomy / the total volume of the hepatic tissue was significantly decreased. The differences between the two groups were statistically significant (P <0.05). The resection rate of HCC in stage II of the study group was significantly increased (P <0.01). The 1, 2, 3-year survival rates of the study group were significantly increased, both of which were significantly different With statistical significance (P <0.01). Conclusion TACE combined with SPVE treatment can further expand the indications of liver resection in advanced liver cancer, improve the resection rate of liver cancer and prolong the life cycle of patients with liver cancer, which is the ideal surgical plan.