肝癌的双介入治疗评价

原发性肝癌 (ＨＣＣ)在我国发病率较高 ,一旦发现多属中晚期。其治疗长期以来依靠外科手术 ,而符合手术切除适应证的病人较少 ,手术切除率仅为 11 9% [1] 。随着介入放射学在临床应用的日益普及 ,经导管肝动脉化疗栓塞 (ＴＡＥ)已广泛地应用于肝癌的治疗 ,并取得了良好的近期疗效 ,但长期生存率仍然不高 ,单纯ＴＡＥ治疗后 3年、5年的生存率分别为 15 %和 6 % [2 ,3 ] 。因此提高肝癌治疗后长期生存率是临床上需探讨的课题 ,我们采用ＴＡＥ联合ＣＴ导引下经皮肝穿刺注入无水乙醇 (ＰＥＩ)的双介入疗法对肝癌患者进行治疗 ,并对其疗效进行评…     

肝癌介入治疗的现状与发展前景

原发性肝癌(以下简称肝癌),是我国常见的恶性肿瘤之一,占消化系肿瘤的第三位,仅次于胃癌和食道癌。由于肝癌起病隐匿,早期缺乏典型症状,一旦发现往往是中晚期,失去手术机会,全身化疗或放疗基本无效,从而使介入治疗成为肝癌的重要手段。     

102例中晚期肺癌,肝癌介入治疗体会

我院自1995年10月～1997年11月先后收治了102例肺癌,肝癌患者行介人治疗共167次,临床疗效满意.现将我们临床诊治体会报道如下:1 临床资料1.1 一般资料男68例,女34例,年龄32岁～83岁,57.5岁.肺癌73例,其中中央型肺癌55例,周围型肺癌及肺癌术后转移18例.病理分类:小细胞癌22例,未     

双介入治疗胰腺癌的护理

采用局部注射及经皮经肝留置胆道支撑管（Ｓｔｅｎｔ）胆汁内引流治疗３２例胰腺癌病人，治疗效果明显，病人的存活率较高。结果表明：消除病人对治疗的恐惧紧张心理；认真做好术前准备；加强术后护理；肝、肾功能的检测及胃肠道反应的观察及护理是提高疗效的重要保证。     

肝癌介入治疗加射频热疗的生存期观察

目的：探讨晚期肝癌介入栓塞化疗（TACE）加射频热疗的生存期。方法：晚期肝癌324例,分为三组,TACE加热疗组107例,TACE组135例,射频热疗组82例。治疗后随访1 a、3 a、5 a患者存活率。结果：3组间3 a和5 a存活率存在统计学差异（P〈0.05）。结论：TACE加射频热疗较介入栓塞治疗或射频热疗存活率高。     

原发性肝癌的介入治疗──“三明治”疗法

原发性肝癌的介入治疗──“三明治”疗法朱文玉，邱建国，吴伟成（江苏省常州市第一人民医院常州２１３００３）肝动脉药物灌注（ＨＡＩ）与栓塞（ＨＡＥ）治疗中晚期原发性肝癌经临床实践证明是一种新的有效方法。我们采用所谓的“三明治”方法，对经ＣＴ、Ｂ超及血管造...     

Prognostic factors for overall survival in prostate cancer patients with different site-specific visceral metastases: A study of 1358patients

BACKGROUND Distant metastasis,particularly visceral metastasis(VM),represents an important negative prognostic factor for prostate cancer(PCa)patients.However,due to the lower rate of occurrence of VM,studies on these patients are relatively rare.Consequently,studies focusing on prognostic factors associated with PCa patients with VM are highly desirable.AIM To investigate the prognostic factors for overall survival(OS)in PCa patients with lung,brain,and liver metastases,respectively,and evaluate the impact of site-specific and number-specific VM on OS.METHODS Data on PCa patients with VM were extracted from the Surveillance,Epidemiology,and End Results database between 2010 and 2015.Univariate and multivariate Cox regression analyses were used to analyze the association between clinicopathological characteristics and survival of patients with different site-specific VM.Kaplan-Meier analyses and Log-rank tests were performed to analyze the differences among the groups.RESULTS A total of 1358 PCa patients with site-specific VM were identified from 2010 to 2015.Older age(>70 years)(P<0.001),higher stage(T3/T4)(P=0.004),and higher Gleason score(>8)(P<0.001)were found to be significant independent prognostic factors associated with poor OS in PCa patients with lung metastases.Higher stage(T3/T4)(P=0.047)was noted to be the only independent risk factor affecting OS in PCa patients with brain metastases.Older age(>70 years)(P=0.010)and higher Gleason score(>8)(P=0.001)were associated with shorter OS in PCa patients with liver metastases.PCa patients with isolated lung metastases exhibited significantly better survival outcomes compared with PCa patients with other single sites of VM(P<0.001).PCa patients with a single site of VM exhibited a superior OS compared with PCa patients with multiple sites of VM(P<0.001).CONCLUSION This is the first Surveillance,Epidemiology,and End Results-based study to determine prognostic factors affecting OS in PCa patients with different sitespecific VM.Clinical assessments of these crucial prognostic factors become necessary before establishing a treatment strategy for these patients with metastatic PCa.     

Prognostic nomograms for predicting overall survival and cause-specific survival of signet ring cell carcinoma in colorectal cancer patients

BACKGROUNDSignet ring cell carcinoma (SRCC) is an uncommon subtype in colorectal cancer (CRC), with a short survival time. Therefore, it is imperative to establish a useful prognostic model. As a simple visual predictive tool, nomograms combining a quantification of all proven prognostic factors have been widely used for predicting the outcomes of patients with different cancers in recent years. Until now, there has been no nomogram to predict the outcome of CRC patients with SRCC.AIMTo build effective nomograms for predicting overall survival (OS) and cause-specific survival (CSS) of CRC patients with SRCC.METHODSData were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Multivariate Cox regression analyses were used to identify independent variables for both OS and CSS to construct the nomograms. Performance of the nomograms was assessed by concordance index, calibration curves, and receiver operating characteristic (ROC) curves. ROC curves were also utilized to compare benefits between the nomograms and the tumor-node-metastasis (TNM) staging system. Patients were classified as high-risk, moderate-risk, and low-risk groups using the novel nomograms. Kaplan-Meier curves were plotted to compare survival differences.RESULTSIn total, 1230 patients were included. The concordance index of the nomograms for OS and CSS were 0.737 (95% confidence interval: 0.728-0.747) and 0.758 (95% confidence interval: 0.738-0.778), respectively. The calibration curves and ROC curves demonstrated good predictive accuracy. The 1-, 3-, and 5-year area under the curve values of the nomogram for predicting OS were 0.796, 0.825 and 0.819, in comparison to 0.743, 0.798, and 0.803 for the TNM staging system. In addition, the 1-, 3-, and 5-year area under the curve values of the nomogram for predicting CSS were 0.805, 0.847 and 0.863, in comparison to 0.740, 0.794, and 0.800 for the TNM staging system. Based on the novel nomograms, stratified analysis showed that the 5-year probability of survival in the high-risk, moderate-risk, and low-risk groups was 6.8%, 37.7%, and 67.0% for OS (P < 0.001), as well as 9.6%, 38.5%, and 67.6% for CSS (P < 0.001), respectively.CONCLUSIONConvenient and visual nomograms were built and validated to accurately predict the OS and CSS rates for CRC patients with SRCC, which are superior to the conventional TNM staging system.     

Chinese herbal medicine therapy and the risk of overall mortality for patients with liver cancer who underwent surgical resection in Taiwan

Liver cancer is the sixth most diagnosed cancer globally, and the second leading cause of cancer-related deaths. Surgical resection is a procedure performed to remove cancerous tissue from the liver. Chinese herbal medicine (CHM) is a complementary natural medicine system widely used for treatment of hepatic diseases in Asian countries. We investigated the effects on overall mortality of long-term use of CHM for treatment of patients with liver cancer who underwent surgical resection at the Taiwan Center for Medicine. We identified 1504 patients with liver cancer who underwent surgical resection. Of these patients, 210 CHM users and 210 non-users were selected, and were matched for age, gender, radiotherapy, and chemotherapy prior to CHM treatment. Chi-squared test, Cox proportional hazard modeling, the Kaplan-Meier method, log-rank test, association rule mining, and network analysis were used as statistical methods in this study. CHM users showed a significantly lower risk of overall mortality than non-users (HR: 0.57, 95% CI = 0.40-0.81; p = 0.0025; multivariate Cox proportional hazard model), and a lower 10-year cumulative incidence of overall mortality (p < 0.05; log rank test). Association rule mining and network analysis suggested that Bai-Hua-She-She-Cao, Ban-Zhi-Lian, and Suan-Zao-Ren were the most effective CHMs. Therefore, we concluded that use of CHM as adjunctive therapy may reduce overall mortality in patients with liver cancer who underwent surgical resection. A list of herbal medicines with potential as future therapeutic interventions to prolong the life-span of patients with liver cancer who underwent surgical resection is also provided.     

重睑成形术患者心理干预的应用研究

目的探讨重睑成形术患者的心理干预措施，评估心理干预的效果。方法将46例重睑成形术患者随机分为对照组和实验组，对照组给予常规护理，实验组在此基础上给予心理干预。采用症状自评量表（SCL-90）分别在手术前及手术后4周进行评估分析。结果术后4周实验组的SCL-90躯体化症状、人际关系敏感、焦虑、抑郁、恐惧、精神病性因子均分均低于对照组，差异具有显著性（P〈0．05）。结论重睑成形术患者术前存在较多的心理症状，实施心理干预能有效地促进患者的身心健康。     

护理干预对肝癌介入治疗患者生存质量的影响

目的：探讨护理干预对肝癌介入治疗患者生存质量的影响。方法：将92例肝癌介入治疗患者随机分为观察组和对照组各46例,对照组给予常规护理,观察组在此基础上进行护理干预。并采用生存质量（QOL）核心量表对两组患者进行调查。结果：观察组躯体功能、心理功能、社会功能评分均高于对照组（P〈0．01）。结论：对肝癌介入治疗患者进行护理干预,可提高患者的生存质量。     

综合护理干预在原发性肝癌介入治疗中的应用

目的：提高原发性肝癌介入手术护理配合质量。方法：选择原发性肝癌介入手术患者125例,随机分为试验组（n=64）和对照组（n=61）,对照组给予常规护理,试验组在对照组的基础上给予综合护理干预。比较两组患者的住院时间、住院费用及主要并发症的发生率。结果：试验组的住院天数为（8．23±1．68）d、住院费用为（10171．10±1116．72）元,对照组的住院天数为（9．62±1．86）d、住院费用为（11186．00±1232．60）元;试验组术后主要并发症发生率为4．69％,而对照组则为13．11％。结论：通过术前准备、术中配合、术后全面护理,以及从心理和生理两方面整体护理介入,可以缩短原发性肝癌介入术后住院时间,减少住院费用以及主要并发症的发生率。     

肝癌患者介入治疗后长期生存的综合分析

目的 探讨影响肝癌患者介入治疗远期疗效的相关因素.方法 回顾性分析495例以经导管动脉化疗栓塞术(TACE)为主要治疗的肝癌患者的临床资料.按介入治疗后患者生存时间的不同分为≥5年组和＜5年组,比较两组间影响患者生存期各因素间的差异.结果 31例患者生存5年以上,肿瘤内碘油沉积类型Ⅰ型者18例,Ⅱ型13例.495例患者5年、7年、10年的存活率分别为6.26%(31/495)、1.41%(7/495)和0.40%(2/495).肿瘤分型、临床分期、血管造影表现、动静脉分流、碘油充填类型、扩散转移、肝功能因素、年龄、肿瘤直径、TACE治疗次数、TACE前后AFP值及其变化对肝癌介入治疗后长期生存存在影响(P均＜0.05).结论 肿瘤分型、患者自身状况、TACE治疗的质量、联合经皮无水乙醇消融(PEI)治疗、抗病毒治疗等因素对肝癌介入治疗的远期疗效有显著的影响.     

肝癌介入术后不良反应的个性化护理干预

目的探讨个性化护理干预对肝癌介入手术治疗后出现不良反应的患者的应用效果。方法选取行肝癌介入手术治疗后发生不良反应的患者27例作为研究对象,以随机数字表法分为对照组及试验组。对照组13例患者接受传统护理干预,试验组14例患者接受个性化护理干预,比较2组护理干预结束后不良反应缓解率、住院时间,并统计护理后生命质量评分和护理质量评估结果。结果试验组患者护理2周后不良反应缓解率为100%、住院时间为(28.9±4.36)d、生活质量评分为(13.4±1.76)分,对照组患者护理2周后不良反应缓解率为69.23%、住院时间为(36.8±5.42)d、生活质量评分为(9.7±2.11)分,2组差异均有统计学意义(P0.05);试验组患者对护理质量的评分显著高于对照组(P0.05)。结论将个性化护理干预应用于肝癌介入手术治疗后出现不良反应的患者中,可有效促进症状缓解,缩短住院时间,提高生活质量。     

肝癌介入治疗72例护理体会

目的：探讨肝癌介入治疗患者的护理方法。方法：对72例肝癌患者加强介入前、介入中、介入后护理,积极给予健康指导。结果：本组症状改善56例,症状稳定14例,恶化6例。3个月生存率为91、3％,半年生存率为80．2％,1年生存率为56．7％。结论：加强肝癌介入治疗的围手术期护理,可提高治疗效果和患者生存率。