射频消融联合化疗栓塞对肝癌肝功能及甲胎蛋白的影响

目的:比较单纯用射频消融方法与射频消融术联合肝动脉化疗栓塞术治疗肝癌对近期肝功能、甲胎蛋白(AFP)的影响及疗效对比。方法:回顾性分析2011年1月至2013年1月郑州大学第一附属医院单纯用射频消融术与射频消融术联合肝动脉化疗栓塞术治疗肝癌患者各30例,治疗前肝功能Child分级A级,观察治疗后第2天的肝功能及1周后AFP变化。结果:单纯射频消融与联合肝动脉化疗栓塞术治疗均可导致丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)升高、AFP下降,联合肝动脉化疗栓塞术治疗还可导致总胆红素(TBiL)、碱性磷酸酶(ALP)升高,与治疗前比较差异均有统计学意义(P<0.05)。两组治疗前后差值比较,联合肝动脉化疗栓塞术治疗能显著升高ALT、ALP,降低AFP,与单纯射频消融比较差异有统计学意义(P<0.05)。结论:在消融范围相等情况下,联合肝动脉化疗栓塞术治疗对近期肝功能及甲胎蛋白的影响比射频消融更为显著。

Effects of radiofrequency ablation combined with transcatheter arterial chemoembolization on liver function and AFP levels in patients with liver cancer

Objective ： To evaluate the effects of radiofrequency ablation （RFA） single used or com- bined with transcatheter arterial chemoembolization（TACE）on the short-term liver function ,alpha fetal protein（AFP） levels in patients with liver cancer. Methods： The data of 60 patients with liver cancer treated with RFA （ n = 30） or RFA combined with TACE （ n = 30） from January 2011 to Janu- ary 2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The liver function of all the patients was grade A by Child classification before the treatment. The liver function in the second day and the change of AFP levels after 1 week were observed after the treat- ment. Results ： Both the two treatments could lead to a rise of alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels and a decline of AFP levels. The combined treatment could also result in a rise of total bilirubin（TBiL）and alkaline phosphatase（ ALP） levels which were sta- tistically significant compared with the preoperative levels （ P 〈 0.05 ）. The combined treatment could cause a rise of the ALT and ALP levels and a decline of AFP levels compared with the single treatment（P 〈 0.05）. Conclusion： Under the same ablation range, RFA combined with TACE could have a better effect on short-term liver function and AFP than RFA single used.