本文選題：原發(fā)性巨大肝癌　切入點(diǎn)：動(dòng)脈化療栓塞術(shù)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過回顧性研究,對(duì)比分析單獨(dú)行經(jīng)導(dǎo)管肝動(dòng)脈化療栓塞(TACE)與采用TACE聯(lián)合經(jīng)皮微波消融術(shù)(PMCT)治療原發(fā)性巨大肝癌的臨床療效、預(yù)后及安全性評(píng)價(jià)。方法:收集2011年9月到2014年9月在我院住院治療的原發(fā)性巨大肝癌(腫瘤最大直徑10cm)91例病例。其中,單獨(dú)采用動(dòng)脈化療栓塞術(shù)治療的患者40例,予納入對(duì)照組,對(duì)照組患者至少接受2次TACE治療;TACE聯(lián)合微波消融術(shù)(PMCT)治療的患者51例,予納入觀察組,觀察組患者至少在接受1次TACE治療后,且通過臨床評(píng)估腫瘤獲得縮小的情況下,繼續(xù)給予微波消融術(shù),必要時(shí)可再行TACE。治療結(jié)束后進(jìn)行隨訪,評(píng)價(jià)兩組的治療效果、臨床預(yù)后及毒副反應(yīng)。結(jié)果:納入本研究的兩組患者均獲得完整隨訪。觀察組患者的完全緩解率、部分緩解率及總體有效率均高于對(duì)照組(p值均小于0.05)。兩組患者治療后Child-pugh評(píng)分均有所降低,且觀察組改善更為明顯(P=0.033)。觀察組患者的中位生存時(shí)間為14個(gè)月,對(duì)照組中位生存時(shí)間為9個(gè)月,差異有統(tǒng)計(jì)學(xué)意義(P0.0013)。觀察組1、2年生存率分別為60.84%、29.20%;對(duì)照組1、2年生存率分別為34.03%、18.52%。兩組患者比較1年生存率(P=0.007)及2年生存率(P=0.001)差異有統(tǒng)計(jì)學(xué)意義。兩組患者均未發(fā)生較為嚴(yán)重的不良反應(yīng),且兩組患者不良反應(yīng)的發(fā)生并無較大差異。結(jié)論:肝動(dòng)脈化療栓塞術(shù)(TACE)聯(lián)合微波消融術(shù)(PMCT)治療原發(fā)性巨大肝癌,較單獨(dú)使用肝動(dòng)脈化療栓塞術(shù)能延長患者的生存時(shí)間,其療效可靠,安全性高,具有良好的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to compare the clinical effects of transcatheter hepatic artery chemoembolization (TACEE) and TACE combined with percutaneous microwave ablation in the treatment of large hepatocellular carcinoma. Methods: from September 2011 to September 2014, 40 patients with large primary liver cancer (10cm)91 with maximum diameter of tumor) treated by arterial chemoembolization alone were collected. In the control group, 51 patients in the control group received at least 2 times of TACE therapy combined with microwave ablation. The patients in the observation group were treated with TACE at least once. After clinical evaluation of the reduction of the tumor, microwave ablation was continued and TACE.After the treatment was finished, the therapeutic effects of the two groups were evaluated. Clinical prognosis and side effects. Results: the two groups of patients in this study were followed up completely. The complete remission rate of the patients in the observation group, The partial remission rate and the total effective rate were higher than those of the control group (P < 0.05). The Child-pugh score of the two groups decreased after treatment, and the improvement was more obvious in the observation group than in the control group. The median survival time of the patients in the observation group was 14 months. The median survival time of the control group was 9 months. The 1- and 2-year survival rates in the observation group were 60.84 and 29.20, respectively, while the 1- and 2-year survival rates in the control group were 34.03and 18.52.The 1-year survival rate and 2-year survival rate were significantly higher than those in the control group (P 0.007) and 2-year survival rate (P0.001). There was no significant difference in the 1- and 2-year survival rates between the two groups. For serious adverse reactions, There was no significant difference between the two groups in the occurrence of adverse reactions. Conclusion: TACE combined with microwave ablation can prolong the survival time of patients with giant primary liver cancer. Its curative effect is reliable, the safety is high, has the good clinical application value.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.7

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