發(fā)布時(shí)間：2018-04-17 15:45

  本文選題：肝癌 + 經(jīng)導(dǎo)管動(dòng)脈化療栓塞��； 參考：《昆明醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：研究TACE聯(lián)合HIFU消融治療肝癌療效和對(duì)患者機(jī)體免疫功能的影響,為TACE聯(lián)合HIFU治療肝癌提供一定的理論依據(jù)。探討TACE聯(lián)合FIFU治療肝癌對(duì)免疫功能的影響及其臨床意義,為臨床上TACE聯(lián)合HIFU治療肝癌的應(yīng)用價(jià)值提供科學(xué)依據(jù)。 方法：收集本院肝癌患者46例,分成單純TACE組(對(duì)照組)及TACE聯(lián)合HIFU治療組(實(shí)驗(yàn)組),每組患者各23例。觀察兩組患者療效及術(shù)前及術(shù)后1、3、6、12個(gè)月免疫指標(biāo)(CD3+T細(xì)胞、CD4+T細(xì)胞、CD8+T細(xì)胞、NK細(xì)胞、CD4+T細(xì)胞/CD8+T細(xì)胞比值)及其臨床癥狀的變化情況。 結(jié)果：對(duì)照組術(shù)后1月與術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值升高,CD8+T比例降低；術(shù)后3月時(shí)與術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值稍升高,CD8+T比例稍降低；術(shù)后6月術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值略有升高,CD8+比例略有降低；術(shù)后12月與術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值略有降低,CD8+比例略有升高。實(shí)驗(yàn)組術(shù)后1月與術(shù)前對(duì)比CD3+、CD4、及NK比例及CD4+／CD8+比值明顯升高,CD8+比例明顯降低；術(shù)后3月與術(shù)前比較CD3+、CD4、及NK比例及CD4+/CD8+比值明顯升高,CD8+比例明顯降低；術(shù)后6月與術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值稍升高,CD8+比例稍降低；術(shù)后12月與術(shù)前比較CD3+、CD4+、及NK比例及CD4+/CD8+比值略有升高,CD8+比例略有降低。兩組數(shù)據(jù)比較,實(shí)驗(yàn)組術(shù)后1月、3月與對(duì)照組比較增高,有統(tǒng)計(jì)意義,術(shù)后6月、12月時(shí)稍高于對(duì)照組,差異沒有統(tǒng)計(jì)學(xué)意義。術(shù)后患者臨床癥狀變化如下：全身乏力明顯改善的聯(lián)合治療組占87.5%(14/16),而對(duì)照組46.7%(7/15)；消瘦明顯改善的治療組占75%(9／12),而對(duì)照組46.15%(6/13)；納差明顯改善的占84.61%(13/15),而對(duì)照組41.67%(5/12)；肝區(qū)疼痛明顯緩解的治療組占75%(11/13),而對(duì)照組42.85%(6/14)。實(shí)驗(yàn)組與對(duì)照組術(shù)后3個(gè)月、6個(gè)月、12個(gè)月的生存率分別為100.00%、91.31%、78.26%與100.00%、69.60%、56.52%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： 1、單純TACE治療后患者免疫功能的改變?yōu)橹委熀?個(gè)月明顯增強(qiáng),3、6、12個(gè)月后免疫功能較治療前改變不明顯。 2、TACE聯(lián)合HIFU消融治療后對(duì)比單純TACE治療后1、3個(gè)月患者免疫功能明顯增強(qiáng),治療后6、12個(gè)月免疫功能與單純TACE治療組相同。 3、TACE聯(lián)合HIFU消融治療肝癌患者改善患者臨床癥狀及提高生存率效果優(yōu)于單純TACE治療。
[Abstract]:Objective: to study the effect of TACE combined with HIFU ablation on liver cancer and its effect on immune function of patients, and to provide a theoretical basis for TACE combined with HIFU in the treatment of HCC.To explore the effect of TACE combined with FIFU on immune function and its clinical significance, to provide scientific basis for the clinical application of TACE combined with HIFU in the treatment of hepatocellular carcinoma.Methods: 46 patients with liver cancer in our hospital were divided into TACE group (control group) and TACE combined with HIFU group (experimental group, 23 cases in each group).To observe the curative effect of the two groups and the changes of CD 3 T cell / CD 8 T cell / CD 8 T cell / T cell / CD 4 / CD 8 T cell ratio and their clinical symptoms before and after operation.Results: in the control group, CD3 CD4, NK ratio and CD4 / CD8 ratio increased and CD8 T ratio decreased at 1 month after operation, and decreased slightly at 3 months after operation compared with preoperative CD3 CD4, NK ratio and CD4 / CD8 ratio.The ratio of CD3 / CD _ 4, NK / CD _ 8 and CD4 / CD _ 8 were slightly increased and the ratio of CD3 / CD _ 4, NK / CD _ 8 and CD4 / CD _ 8 were slightly lower than those before operation at 6 months after operation.The ratio of CD3 / CD _ 4, NK and CD4 / CD _ 8 in the experimental group was significantly higher than that before operation, and the ratio of CD3 / CD _ 4, NK and CD4 / CD _ 8 was significantly lower than that of before operation at 3 months after operation, and the ratio of NK and CD4 / CD _ 8 was significantly higher than that before operation.At 6 months after operation, CD3 CD4, NK ratio and CD4 / CD8 ratio increased slightly, and CD3 T 4, NK ratio and CD4 / CD8 ratio slightly increased and CD8 ratio decreased slightly.The data of the two groups were higher than that of the control group in 1 month and 3 months after operation, and the difference was not statistically significant at 6 months and 12 months after operation, which was slightly higher than that in the control group.The clinical symptoms of the patients after operation were as follows: the patients in the combined treatment group with obvious improvement in general fatigue accounted for 14 / 16, while the control group had 46.7 / 7 / 15; the treatment group with obvious improvement of weight loss accounted for 75 / 912 / 12, while the control group with 46.15% / 13 / 13; the group with significantly improved anorexia accounted for 84.61 / 13 / 15, while the control group with 41.67 / 5 / 12; and the control group with pain in the liver area.The significant remission group accounted for 75 / 11 / 13 and the control group 42.85 / 14.The survival rates of the experimental group and the control group at 3 months, 6 months and 12 months after operation were 100.00,91.31% and 100.0069.60% respectively. The difference was statistically significant (P 0.05).Conclusion:1. The changes of immune function in patients treated with TACE alone were significantly enhanced at one month after treatment, and the immune function was not changed significantly after 12 months compared with that before treatment.2the immune function of the patients treated with TACE combined with HIFU ablation was significantly enhanced after 1 and 3 months of TACE treatment, and the immune function was the same as that of the simple TACE treatment group at 6 and 12 months after the treatment.3 the effect of TACE combined with HIFU ablation on improving clinical symptoms and improving survival rate of patients with liver cancer was better than that of TACE alone.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R735.7;R445.1

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