【摘要】 目的 探讨射频消融术（RFA）联合经导管动脉栓塞化疗（TACE）治疗原发性大肝癌的疗效。方法 根据治疗方式的不同将96例原发性大肝癌患者分为对照组和观察组，每组48例，对照组患者给予TACE治疗，观察组患者给予TACE联合RFA治疗，两组患者均给予综合干预。比较两组患者肝功能指标[总胆红素（TBIL）、丙氨酸转氨酶（ALT）、甲胎蛋白（AFP）]、免疫功能指标[CD3~+、CD4~+、CD8~+、自然杀伤（NK）细胞]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表（EORTC QLQ-C30）]、并发症发生情况、随访2年生存情况和肿瘤直径。结果 治疗后1个月，两组患者TBIL、ALT、AFP、CD8~+水平均低于本组治疗前，CD3~+、CD4~+、NK细胞水平均高于本组治疗前，且观察组患者TBIL、ALT、AFP、CD8~+水平均低于对照组，CD3~+、CD4~+、NK细胞水平均高于对照组，差异均有统计学意义（P﹤0.05）。治疗后1个月，两组患者EORTC QLQ-C30量表各维度评分均高于本组治疗前，且观察组患者EORTC QLQ-C30量表各维度评分均高于对照组，差异均有统计学意义（P﹤0.05）。随访1、2年，观察组患者的总生存率均高于对照组，差异均有统计学意义（P﹤0.05）。治疗后1个月，两组患者的肿瘤直径均小于本组治疗前，且观察组患者的肿瘤直径小于对照组，差异均有统计学意义（P﹤0.05）。结论 RFA联合TACE治疗原发性大肝癌的效果明显优于TACE单独治疗，能够明显改善患者的肝功能及免疫功能指标，且不增加并发症发生风险，有助于提高生活质量及生存率。更多还原

【Abstract】 Objective To investigate the efficacy of radiofrequency ablation (RFA) combined with transcatheter arte‐rial chemoembolization (TACE) in the treatment of primary large liver cancer.Method A total of 96 patients with prima‐ry large liver cancer were collected and divided into control group and observation group according to different treatment methods,with 48 cases in each group.The patients in the control group were treated with TACE,and the patients in the observation group were treated with TACE combined with RFA.Both groups were given comprehensive intervention.Liver function indexes[total bilirubin (TBIL),alanine aminotransferase (ALT),alpha-fetoprotein (AFP)],immune func‐tion indexes[CD3~+,CD4~+,CD8~+,natural killer (NK) cell],quality of life[European Organization for Research and Treat‐ment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30)],complications,2-year follow-up survival,and tumor diameter were compared between the two groups.Result One month after treatment,the levels of TBIL,ALT,AFP and CD8~+in the two groups were lower than those before the treatment,and the levels of CD3~+,CD4~+and NK cell were higher than those before the treatment,and the levels of TBIL,ALT,AFP and CD8~+in the observation group were lower than those in the control group,the levels of CD3~+,CD4~+and NK cell were higher than those in the control group,with differences were statistically significant (P<0.05).One month after treatment,the scores of each dimension of EORTC QLQ-C30 scale in the two groups were higher than those before treatment,and the scores of each dimension of EORTC QLQ-C30 scale in the observation group were higher than those in the control group,with differences were statis‐tically significant (P<0.05).After 1 and 2 years of follow-up,the overall survival of the observation group were higher than those of the control group,and the differences were statistically significant (P<0.05).One month after the treatment,the tumor diameters of the two groups were smaller than those before the treatment,and the tumor diameters of the obser‐vation group was smaller than that of the control group,and the differences were statistically significant (P<0.05).Conclu‐sion The effect of RFA combined with TACE in the treatment of primary large liver cancer is significantly better than that of TACE alone,and it can significantly improve the liver function and immune function indicators of patients without increasing the risk of adverse events.Therefore,it does help improving patients’quality of life and survival.更多还原