【作者】 邓超；

【导师】 贾明库；

【作者基本信息】 吉林大学 ， 临床医学， 2008， 硕士

【摘要】 目的:探讨原发性肝癌患者给予不同治疗方法对治疗效果的影响,评价原发性肝癌综合治疗的疗效。方法:回顾性分析随访满2年的117例原发性肝癌患者的治疗方法及治疗效果。其中包括男性103例,女性14例,平均年龄48.72岁。行手术治疗76例,其中单纯肝癌根治性切除21例,肝癌根治性切除联合综合治疗55例,非手术治疗41例。对比单纯手术组及手术联合综合治疗组1年和2年肝内复发率,对比不同治疗方法各组间1年和2年生存率,记录治疗后并发症的发生。结果:综合治疗组1年和2年的肝内复发率分别为9.09%(5/55)和32.73%(18/55),单纯手术组为42.86%(9/21)和61.90%(13/21),两组之间有显著性差异(p<0.05);综合治疗组1年和2年的生存率分别为92.73%(51/55)和65.45%(36/55),单纯手术组为71.43%(15/21)和38.10%(8/21),非手术治疗组为41.46%(17/41)和12.20%(5/41),三组之间均有显著性差异(p<0.05)。各种治疗方法均有不同程度并发症发生。结论:手术治疗仍为肝癌的主要治疗方法,以手术联合综合治疗的疗法是目前原发性肝癌的理想治疗模式,可降低肝内复发率,延长患者生存期,并且在积极治疗的同时应注意预防、及时处理各种手术及介入并发症。更多还原

【Abstract】 As one of the most common malignant tumors, 1 million new cases of primary liver carcinoma are reported annually all over the world. A survey indicates that 53% of annual incidence of this disease, listed as the No.2 culprit for death in malignant tumors in Chian, occurs in its mainland part.The specialized characters of primary liver carcinoma, such as its occult occurrence and rapid growth, earns its name as the most formidable disease in malignant tumors and therefore makes it imperative to work out new methods concerning early diagnosis and efficient therapy.Recent progress in medical imaging technology and the application of AFP examination contributes greatly to the early diagnosis of this disease hence sheds lights on early treatment for many patients.However, traditional operation still serves as the most important treatment since limited progress is achieved in therapies aimed atimproving prognosis, Recent improvements in medical technologyand traditional therapies supply versatile methods to both surgical and non-surgical treatments. New surgical ways, such as hepatectomy, hepatic artery ligation, operative hepatic artery embolization, drug delivery system, operative ethanol injection, microwave coagulation therapy, radio frequency ablation; together with non-surgical means, such as transcatheter arterial chemoembolization, percutaneous ethanol injection,radiotherapeutics, targeted therapy, traditional Chinese medicine,and so on are among the top hot issues.Comprehensive and individualized therapy has become the focus of research hence guides the direction of future studies concentrating on improving prognosis. And Operation-dominated comprehensive therapy is generally believed to be the optimal therapeutic mode for patients.Objective To investigate the therapeutic effects of different therapies for primary liver cancer(PLC),and evaluations of the comprehensive treatment for PLC. Methods A retrospective analysis concerning the effects of different therapies for PLC based upon a 2-year follow up of 117 PLC patients was conducted. There were 103 male and 14 female patients with an average age of 48.72 years old. 76 patients underwent hepatectomy. In this group, 21 patients received simple hepatectomy, 55 patients received the hepatectomy and postoperative comprehensive treatment. The rest 41 patients received therapies other than hepatectomy. We compared the recurrent rate of the simple hepatectomy group with that of the comprehensive treatment group at the end of the 1st and 2nd year after the operation as well as the survival rate among different therapeutic groups simutaneously. Postopeative complications were also taken into account.Results Among the comprehensive treatment group, the overall 1st and 2nd year recurrent rate were 9.09%(5/55)and 32.73%(18/55) repectively; while in simple hepatectomy group, the results were 42.86%(9/21)and 61.90%(13/21)accordingly. Significant difference between two groups was witnessed(p<0.05). The 1st and 2nd year survival rate of the comprehensive treatment group were 92.73%(51/55)and 65.45%(36/55)compared with 71.43%(15/21)and 38.10%(8/21)in simple hepatectomy group. In non- hepatectomy group, the survival rates turned out to be 41.46%(17/41)and 12.20%(5/41). The significant difference among these groups was confirmed (p<0.05) while diverse complications to different extents ensued after every kind of therapeutic method.Conclusion Hepatectomy, followed by comprehensive treatment, still serves as the most important and the most proper therapy for PLC currently, not only because of reducing the recurrent rate but also prolonging the survival period. Furthermore,t he necessity of preventing ensuing complications should be underlined aimed at enhancing the therapeutic effects.更多还原