原发性肝癌切除术后行肝动脉化疗栓塞治疗的疗效观察

目的探究原发性肝癌切除术后行肝动脉化疗栓塞术（TACE）治疗的效果。 方法回顾性分析梧州市红十字会医院2006年1月至2015年12月接受原发性肝癌切除术的513例患者临床资料，其中343例术后接受TACE治疗作为研究组，170例术后未接受TACE治疗作为对照组。对比两组患者术后TACE的治疗效果，并随访观察两组患者化疗前后肝功能情况。 结果两组患者的基础资料相比差异无统计学意义。研究组随访12~36个月，复发率为33.82%（116/343）；对照组随访12~32个月，复发率为43.53%（74/170），两组差异具有统计学意义（χ²=4.596，P=0.032）；研究组的无瘤生存率高于对照组（66.76% vs 47.65%，χ²=17.371，P<0.01），无瘤生存时间长于对照组（20.27±5.49）个月vs（13.34±5.06）个月，t=13.806，P<0.001]。同组相比，研究组治疗后的肝功能指标AST、ALT、TBIL和ALB均明显低于治疗前，对照组治疗后仅较治疗前ALB降低（均P<0.05）。组间相比，治疗后研究组AST、TBIL和ALB三项指标水平均低于对照组，差异有统计学意义（t=7.754，P<0.001；t=2.252，P=0.025；t=13.345，P<0.001）。研究组的并发症发生率为46.94%，对照组未见类似并发症。 结论原发性肝癌患者切除术后行TACE治疗，能有效提升患者的治疗效果和预后情况，但会进一步加重对患者肝功能的损伤，增加患者并发症的发生率，应引起临床重视。

Effect of transcatheter arterial chemoembolization on primary hepatocellular carcinoma after resection

ObjectiveTo explore the effect of transcatheter arterial chemoembolization (TACE) after primary hepatectomy. MethodsA total of five hundred and thirteen patients receiving primary hepatectomy from January 2006 to December 2015 in Wuzhou Red Cross Hospital were collected, among whom 343 were treated with TACE as the study group and the 170 patients not received TACE as the control group. The therapeutic effect of TACE was compared between the two groups, and the liver function before and after chemotherapy was observed. ResultsThere was no statistically significant difference between the two groups of general data. The study group was followed up for 12 to 36 months with recurrence rate of 33.82% (116/343) and the control group was followed up for 12 to 32 months with 43.53% (74/170), the difference between the two groups was statistically significant (χ²=4.596, P=0.032). The survival rate of the study group was higher than the control group (66.76% vs 47.65%, χ²=17.371, P<0.01), and the survival time without tumor was longer than the control group (20.27±5.49) months vs (13.34±5.06) months, t=13.806, P<0.001]. AST, ALT, TBIL and ALB, the liver function indexes level of the study group were significantly lower than those before treatment, and ALB in the control group were decreased (all P<0.05). Compared with the control group, AST, TBIL and ALB in the study group were lower than those in the control group, the differences were statistically significant (t=7.754, P<0.001; t=2.252, P=0.025; t=13.345, P<0.001). The complication rate was 46.94% in the study group while no similar complication in the control group. ConclusionFor patients with primary liver cancer, undergoing TACE after resection can effectively improve the patient’s treatment and prognosis, but will further increase the liver function of patients with injury and the incidence of complications in patients, and calls for clinical attention.