【摘要】 目的研究用明胶海绵颗粒辅以碘油乳剂经肝动脉介入栓塞治疗巨块型肝癌的临床疗效。方法91例巨块型肝癌的患者随机分为研究组46例和对照组45例,对照组应用碘油乳剂配合表柔比星行肝动脉介入化疗栓塞术,研究组应用明胶海绵颗粒及碘油乳剂配合表柔比星行肝动脉介入化疗栓塞术。比较两组肿瘤坏死率、肿瘤直径、甲胎蛋白水平、肝功能、不良反应及随访期生存情况。结果研究组肿瘤坏死率显著优于对照组(P<0.05)。两组治疗后1个月肿瘤直径均明显缩小(P<0.05)。研究组治疗后3个月肿瘤直径继续降低,但与治疗后1个月无显著差异(P>0.05)。对照组治疗后3个月肿瘤直径有所增大,但与术前及术后1个月均无显著差异(P>0.05)。治疗后两组甲胎蛋白水平均降低(P<0.05),但治疗后两组无显著差异(P>0.05)。治疗后研究组AST、ALT显著升高,ALB及CHE显著下降,对照组ALB及CHE显著下降,研究组AST、ALT水平显著高于对照组(P<0.05)。两组患者术后3、6个月生存率无显著差异(P>0.05),研究组术后9、12个月生存率显著高于对照组(P<0.05)。结论用明胶海绵颗粒辅以碘油乳剂经肝动脉介入栓塞治疗巨块型肝癌可显著提升近期疗效,延长患者生存期,且与单纯应用碘油乳剂栓塞相比不会明显增加不良反应。更多还原

【Abstract】 Objective To study the clinical effect of the application of the interventional embolization of hepatic artery with gelatin sponge particles in the treatment of giant hepatic carcinoma. Methods 91 cases of patients with giant liver cancer were randomly divided into the study group and the control group. The control group only used the iodine oil emulsion in the treatment of hepatic artery interventional chemotherapy embolization. The study group used gelatin sponge particles and iodine oil emulsion combined with the implementation of hepatic arterial chemoembolization. The tumor necrosis rate,the tumor diameter,the level of the fetal protein,liver function,adverse reaction and survival of the follow-up period were compared.Results The tumor necrosis rate in the study group was significantly higher than that in the control group( P < 0. 05). The tumor diameter between two groups had no significant difference( P > 0. 05). After 1 month treatment the tumor diameter were significantly reduced( P < 0. 05),and the diameter of the tumor in the study group 3 months after treatment was reduced,but had no significant difference compared with 1 month treatment( P > 0. 05). The tumor diameter in the control group was increased 3 months after treatment,but there was no significant difference between before operation and 1 months after operation( P >0. 05). There was no significant difference of AFP between the two groups before and after treatment( P > 0. 05),and the two groups were better than before treatment( P < 0. 05). The liver function showed no significant difference between the two groups before treatment. After treatment,CHE,ALB,ALT and AST were significantly decreased,and TBIL was not significantly changed. After treatment,ALB and CHE were significantly decreased,and the other indicators had no significant change. After treatment,the levels of ALT and AST in the study group were significantly higher than those in the control group after treatment,and there were no significant differences between the two groups. There was no significant difference in the incidence of adverse reactions between the two groups( P > 0. 05). The survival rate of 3 and 6 months after treatment had no significant difference( P > 0. 05). The survival rate of 9 months and 12 months after treatment was significantly higher than that of the control group( P < 0. 05). Conclusion Massive type hepatocellular carcinoma( HCC) implementation of hepatic artery interventional embolization with gelatin sponge particles combined with lipiodol emulsion can significantly improve the curative effect in the near future,prolong the survival time of the patients and no significant increase in adverse reactions compared with the simple application of lipiodol emulsion embolization.更多还原