【摘要】 目的　探讨经动脉化疗栓塞术 (TACE)中化疗药物的用量对患者生存期与肝功能、术后副反应的影响。资料与方法　 341例肝癌患者 ,随机分为A、B两组 ,分别行TACE术。化疗药物 :A组小剂量组 (16 8例 ) ,丝裂霉素10mg与碘油乳化栓塞。B组常规剂量组 (173例 ) ,给予丝裂霉素 10mg ,5 氟尿嘧啶 10 0 0mg ,表阿霉素 4 0mg ,羟基喜树碱 4 0mg中的 3种联用后碘油与化疗药物乳化剂栓塞 ,随后用明胶海绵粒或聚乙烯醇 (PVA)微球栓塞。TACE术前、术后 3d、7d、2 8d分别行肝功能检查 ,比较丙氨酸转氨酶 (ALT)、天冬氨酸转氨酶 (AST)、总胆红素 (TBIL)、直接胆红素 (DBIL)、白蛋白 (ALB)、白蛋白 /球蛋白比值 (A/G比值 )以及患者术后腹痛、腹胀、恶心呕吐、发热、消化道出血等副反应的发生状况 ,并比较两组患者生存率有无显著差异。结果　两组 1年内平均生存率无明显差异。A、B两组术后 4周内肝功能ALT、AST和A/G比值均无显著性差异 (P >0 .0 5 ) ,术后第 4周 ,A、B两组间比较 ,B组TBIL和DBIL高于A组 ,ALB低于A组 (P <0 .0 5 )。术后腹痛、腹胀、恶心呕吐、发热、消化道出血等副反应的发生率B组明显高于A组 (P <0 .0 5 )。结论　小剂量TACE与常规剂量TACE组患者的生存率没有显著的差异。小剂量TACE对患者的肝功能损伤较更多还原

【Abstract】 Objective To discuss the effect of chemotherapeutic dose on the survival period, hepatic function and occurrence of side effects in the treatment of hepatic carcinoma with transarterial chemoembolization (TACE). Materials and Methods TACE was performed in 341 patients with hepatic carcinoma, which were randomly divided into group A (low dose group, n=168) and group B (conventional dose group, n=173). Patients in the group A received 10mg mitomycin C, while patients in the group B received 10 mg mitomycin C, 1000mg 5-Fu, 40mg epirubicin and 40mg hydroxy-camptothecinev. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB) and albumin/globulin ratio (A/G ratio) were estimated both before and at 3d, 7d and 28d after TACE procedure. The side effects, such as abdominal pain, abdominal distension, nausea, vomiting, fever, digestive tract hemorrhage, etc., as well as the survival period were observed and compared between two groups. Results No significant difference in the survival rate within one year after TACE procedure was found between two groups. ALT, AST and A/G ratio showed no obvious difference between two groups in 4 weeks after TACE (P>0.05). At 4 weeks after TACE, TBIL and DBIL in the group B were higher, while ALB was lower, than that in the group A (P<0.05). The occurrence of side effects in the group B was significantly higher than that in the group A (P<0.05).Conclusion No significant difference in survival rate exists between small dose TACE and conventional dose TACE. Low dose TACE produces less hepatic damage and less side effects. Therefore, low dose TACE is worth adopting in the clinical practice.更多还原