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目的探讨多次肝动脉化疗栓塞(TACE)预防原发性肝癌(HCC)术后复发的临床疗效。方法回顾性收集2008年1月至2009年7月间HCC根治术后患者68例,其中单纯手术治疗的患者40例(对照组)和术后接受三次预防性TACE的患者28例(研究组),研究组患者均于术后1～2月给予首次预防性TACE,此后每隔2～4个月重复一次,总共三次。全部病例在根治术后随访36～40个月,对比分析两组间1、2、3年的累计复发率。结果 HCC根治术后,对照组1、2、3年累计复发率分别为57.5%、65.0%、67.5%。研究组1、2、3年累计复发率分别为7.1%、25.0%、28.6%。统计学分析研究组1、2、3年复发率均明显低于对照组(P值均<0.05)。研究组所有患者TACE术后副反应较轻,未出现严重并发症。结论 HCC根治术后给予三次预防性TACE是安全有效的,可显著降低术后复发率,延长肝癌患者无瘤生存期。
Objective To investigate the clinical efficacy of multiple transcatheter arterial chemoembolization (TACE) in preventing postoperative recurrence of primary hepatocellular carcinoma (HCC). Methods A total of 68 patients with HCC undergoing radical operation between January 2008 and July 2009 were retrospectively studied. Among them, 40 patients undergoing simple surgery (control group) and 28 patients undergoing three preventive TACE after surgery (study group) All patients in the study group received the first prophylactic TACE from January to February after surgery, and thereafter repeated every 2 to 4 months for a total of three times. All cases were followed up for 36 to 40 months after radical operation, and the cumulative recurrence rates of one, two and three years were compared between the two groups. Results After the radical operation of HCC, the recurrence rates at 1, 2 and 3 years in control group were 57.5%, 65.0% and 67.5% respectively. The cumulative recurrence rates of the study group in 1, 2 and 3 years were 7.1%, 25.0% and 28.6% respectively. Statistical analysis The recurrence rates in study group 1, 2 and 3 years were significantly lower than those in control group (all P <0.05). All patients in the study group had less side effects after TACE, and no serious complications occurred. Conclusions Three prophylactic TACE after radical resection of HCC is safe and effective, which can significantly reduce the recurrence rate and prolong the tumor-free survival of HCC patients.