微创介入治疗复发性肝癌临床疗效分析-论文.pdf

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1、第20卷2期天津医科大学学报V01．20．No．21442014年3月JournalofTianjinMedicalUniversityMar．2014文章编号1006—8147(2014)02—0144—03诊警微创介入治疗复发性肝癌临床疗效分析孟令凯，何向辉，章志翔(天津医科大学总医院普通外科，天津300052)摘要目的：评价经皮肝穿射频消融术(PRFA)联合肝动脉化疗碘油栓塞术(rAcE)介入治疗复发性肝癌的临床效果，为临床制定以及选择治疗方法提供依据。方法：收集复发性肝癌患者临床资料70例，均行超声引导下P

2、RFA联合TACE介入治疗。分析其近期临床治疗疗效并随访生存情况。结果：近期有效率(CR+PR)为85．71％，甲胎蛋白(AFP)转阴率为75．O％，AFP下降超过50％者为95．83％，术后均有不同程度的消化道反应、肝脏生化指标改变等，6例发生较重并发症(肝功能衰竭1例、腹水2例、胆囊炎3例)，经积极纠正无治疗期死亡。6个月、12个月、24个月生存率分别为76_3％、52．6％、34．2％。结论：PRFA联合TACE治疗无手术适应征的复发性肝癌近期疗效确切，可获得满意的远期生存时间，是非手术综合治疗中安全有效的方

3、法之一，值得临床推广。关键词经皮肝射频消融术；肝动脉化疗栓塞术；介入治疗；肝癌复发；生存率中图分类号R735．7文献标志码AClinicalcurativeeffectofminimaUyinvasiveinterventionaltreatmentonrecurrentlivercancerMENGLing—kai，HEXiang—hui，ZHANGZhi-xiang(DepartmentofGeneralSurgery，GeneralHospital，TianjinMedicalUniversity，Tianj

4、in300052，China)Abstract0bjective：Toevaluatetheclinicaleficacyofpereutaneousradiofrequencyablation(PRFA)combinedwithtranscatheterarterialchemoembolization(TACE)inthetreatmentofpostoperativerecurrenceofpfima~hepaticcarcinomaandprovideabasisfortheselectionofclini

5、caltreatment．Methods：Clinicaldataof70patientswithrecurrenthepaticcarcinomaafterunderwenthepatectomywithcompleteresectionoftumorwerecollected．Theinterventionaltherapythatcombinedultrasound—guidedPRFAwithTACEwasappliedtotherecurringpatients．Recentclinicaleficacy

6、andsurvivalrateswereanalyzed．Results：Recentclinicaleficacyratefcompleterelief＆partialrelieOwas85．71％whilethenegativeconversionrateand50％descendingrateofAFPwere75．0％and95．83％。respectively．Allcaseshaddifferentdegreesofthedigestivetractreaction，hepaticpostoperati

7、vebiochemicalindexchange，etc．Sixcaseshadmoreseverecomplicationsliverfailureinlcase，ascitesin2cases，cholecystitisin3cases)，withnomortalityafteractivetreatmentduringtherapyperiod．Thesurvivalratesin6，12，24monthswere76-3％，52．6％，34．2％，respectively．Conclusion：Therec

8、entclinicaleficacyofPRFAcombinedwithTACEinthetreatmentofrecurrentlivercancerisreliable．withconvincedlong—termsurviva1．TheinterventionaltherapythatcombinesPRFAwithTACE，servingasoneo