本文關鍵詞：肝動脈化療栓塞聯(lián)合射頻消融治療乏血供大肝癌的療效分析　出處：《安徽醫(yī)科大學》2015年碩士論文　論文類型：學位論文

  更多相關文章： 乏血供 肝腫瘤 化學栓塞 射頻消融

【摘要】：目的肝癌是我國常見的惡性腫瘤之一,其發(fā)生及發(fā)展很大程度取決于腫瘤的血供情況,不同血供類型對其診斷、治療方式的選擇、療效及預后判斷均有重要意義。對于富血供的肝癌,肝動脈化療栓塞術(transcatheter arterial chemoembolization,TACE)是被臨床證實的有效治療手段,但對于乏血供肝癌,單純TACE治療療效欠佳,且易發(fā)生術后肝功能損傷及其他并發(fā)癥。因此,如何提高乏血供肝癌的療效,是臨床關注的問題。本研究旨在評價和探討TACE聯(lián)合射頻消融(Radiofrequency ablation,RFA)治療晚期乏血供大肝癌的療效。方法回顧性分析我院2008年10月-2014年7月收治的40例晚期乏血供大肝癌患者的臨床資料,隨機分為2組:聯(lián)合治療組(TACE聯(lián)合RFA治療,21例)、對照組(單純TACE治療,19例)。兩組分別于術前、術后1個月抽取靜脈血檢測血清甲胎蛋白(alpha fetoprotein,AFP)含量;術前、術后1周、2周、3周分別檢測血清谷丙轉(zhuǎn)氨酶(Alanine aminotransferase,ALT)和谷草轉(zhuǎn)氨酶(Aspartate transaminase,AST)含量,術前、術后1個月、3個月、6個月復查電子計算機斷層掃描(Computed Tomography,CT)或磁共振成像(Magnetic Resonance Imaging,MRI)平掃加增強掃描;分析腫瘤病灶的大小、壞死程度、術后甲胎蛋白及肝功能變化來評估療效。結(jié)果兩組術前AFP、ALT、AST、腫瘤大小比較差異無統(tǒng)計學意義(P0.05)。各組術與前術后AFP含量對比,差異有統(tǒng)計學意義(P0.05)。兩組術后AFP下降程度對比,差異無統(tǒng)計學意義(P0.05)。聯(lián)合治療組術后腫瘤縮小率和完全壞死率高于對照組(P均0.05);聯(lián)合治療組術后腫瘤進展率低于對照組(P0.05)。結(jié)論1、TACE聯(lián)合RFA治療乏血供肝癌近期療效明顯優(yōu)于單純TACE治療。2、TACE聯(lián)合RFA治療乏血供肝癌安全可靠。
[Abstract]:Objective hepatocellular carcinoma is one of the most common malignant tumors in China. Its occurrence and development largely depend on the blood supply of the tumor. Different blood supply types are of great importance for its diagnosis, treatment options, curative effect and prognosis. Transcatheter arterial chemoembolization (TACE) is a clinically proven effective treatment for hepatocellular carcinoma with rich blood supply. However, for the patients with hepatocellular carcinoma, the effect of TACE alone is not good, and it is easy to cause liver dysfunction and other complications after operation. Therefore, how to improve the curative effect of blood supply for liver cancer is a problem of clinical concern. The purpose of this study was to evaluate and evaluate the efficacy of TACE combined with Radiofrequency ablation (RFA) in the treatment of advanced hypoxia for large liver cancer. Methods the clinical data of 40 patients with advanced hepatocellular carcinoma (HCC) who had received advanced blood transfusion in our hospital from October 2008 to July -2014 were retrospectively analyzed. They were randomly divided into 2 groups: combination therapy group (TACE combined with RFA treatment, 21 cases), control group (simple TACE treatment, 19 cases). The two groups respectively before operation and 1 months after extraction of venous blood serum alpha fetoprotein (alpha fetoprotein, AFP) content; preoperative and postoperative 1 weeks, 2 weeks and 3 weeks respectively to detect serum alanine aminotransferase (Alanine aminotransferase ALT) and aspartate aminotransferase (Aspartate transaminase, AST) content. The preoperative and postoperative 1 months, 3 months, 6 months computedtomography (Computed Tomography, CT) or magnetic resonance imaging (Magnetic Resonance, Imaging, MRI) plain and enhanced scan; analysis of tumor size, necrosis, degree of postoperative AFP and liver function change to evaluate the efficacy. Results there was no significant difference in the size of AFP, ALT, AST and tumor size before operation (P0.05) in the two groups. The difference of AFP content in each group was statistically significant (P0.05). There was no significant difference in the degree of AFP decline between the two groups (P0.05). The rate of tumor reduction and complete necrosis after operation in the combined treatment group was higher than that of the control group (P 0.05), and the tumor progression rate in the combined treatment group was lower than that of the control group (P0.05). Conclusion 1, TACE combined with RFA in the treatment of hypoxic liver cancer is better than that of TACE alone. 2, TACE combined with RFA in the treatment of hypovascular liver cancer is safe and reliable.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.7
，

本文編號：1347014