抗病毒联合经导管肝动脉化疗栓塞治疗乙型肝炎后肝硬化合并肝细胞癌患者的临床观察

目的探讨抗病毒联合经导管肝动脉化疗栓塞(TACE)治疗在乙型肝炎后肝硬化合并肝细胞癌(HCC)患者中的临床疗效。方法回顾性分析抗病毒联合TACE治疗78例乙型肝炎后肝硬化合并HCC患者的临床疗效,并与同期单独行TACE患者81例对比,观察比较两组患者1、2年生存率、肝功能Child-Pugh积分及HBV DNA定量的变化。两组基线临床资料(如性别、年龄、肿瘤的大小、实验室检查及Child-Pugh评分)比较差异无统计学意义(P均>0.05)。结果治疗1、2年后,治疗组HBV DNA阴转率均显著高于对照组(P均<0.0001),肝功能Child-Pugh积分治疗组明显低于对照组(P均<0.001),差异均有统计学意义。治疗组和对照组1、2年生存率分别为83.33%、66.67%和59.2%、36.67%(P均<0.001),差异均有统计学意义。结论应用核苷酸类似物联合TACE治疗乙型肝炎后肝硬化合并HCC的患者,可抑制HBV复制,保护患者肝功能,提高患者生存率。

Clinical study of antiviral treatment combined with transcatheter arterial chemoemholization(TACE) in patients with hepatitis B cirrhosis complicated hepatocellular carcinoma

Objective To investigate the effects of antiviral treatment combined with transcatheter arterial chemoemholization(TACE)in patients with hepatitis B cirrhosis complicated hepatocellular carcinoma(HCC).Methods Retrospectively analyzed the effects of antiviral treatment combined with TACE in 78 cases with Hepatitis B cirrhosis complicated HCC,and compared with 81 patients that separately used TACE at the same time.One or two years′ survival rate,Child-Pugh score and HBV DNA were measured.There were no significant differences between two groups in basic clinical materials(P>0.05)(include sex,age,tumor size,laboratory examination and Child-Pugh score).Results After one or two years′ treatment,the conversion rates of HBV DNA of treatment group were significantly higher than those of the control group(P<0.0001),Child-Pugh scores of treatment group were significantly lower than those of the control group(P<0.001),the differences were significantly.The one or two years′ survival rates of treatment group were 83.33% and 66.67%,while control group were 59.2% and 36.67%(P<0.001),the differences were significantly.Conclusion Nucleoside analogues combined with TACE,can reduce the level of HBV DNA,protect liver functions and increase survival rates considerably in patients with hepatitis B cirrhosis complicated HCC.