本文選題：肝腫瘤 + 動靜脈瘺�。� 參考：《放射學(xué)實踐》2017年05期

【摘要】：目的:探討化療栓塞治療原發(fā)性肝癌合并肝動靜脈瘺(HAVS)的臨床療效及影響預(yù)后的因素。方法:67例不能手術(shù)切除的原發(fā)性肝癌合并HAVS患者行化療栓塞治療,觀察HAVS栓塞效果及近期、遠期療效。應(yīng)用Kaplan-Meier法、Log-rank檢驗進行患者的生存率分析,Cox回歸模型進行多因素分析。結(jié)果:67例HAVS中肝動脈-門靜脈瘺59例,肝動脈-肝靜脈瘺8例;輕、中度動靜脈瘺53例,重度動靜脈瘺14例。HAVS完全栓塞44例(65.7%),輕、中度動靜脈瘺的完全栓塞率(73.6%,39/53)高于重度動靜脈瘺(35.7%,5/14),差異有統(tǒng)計學(xué)意義(χ~2=7.04,P=0.008)。67例患者中,完全緩解(CR)2例,部分緩解(PR)29例,疾病穩(wěn)定(SD)30例,疾病進展(PD)6例,總有效率為46.7%(31/67)。67例患者1年生存率為49.3%,中位生存期為11.0個月。單因素分析結(jié)果顯示腫瘤大小(8cm/≥8cm)、血管瘤栓(有/無)、術(shù)前AFP水平(400/≥400ng/mL)、碘油沉積類型(Ⅰ+Ⅱ/Ⅲ)、瘺口栓塞效果(瘺消失/未消失)的生存率差異有統(tǒng)計學(xué)意義(P0.05),Cox模型多因素分析顯示腫瘤大小、碘油沉積類型是生存率的獨立預(yù)后因素。結(jié)論:化療栓塞治療原發(fā)性肝癌合并HAVS有效,腫瘤大小、碘油沉積類型是獨立的預(yù)后因素。
[Abstract]:Objective: to investigate the clinical efficacy and prognostic factors of chemoembolization in the treatment of hepatocellular carcinoma with hepatic arteriovenous fistula. Methods 67 unresectable patients with primary liver cancer combined with HAVS were treated with chemoembolization. The effect of HAVS embolization and the short-term and long-term results were observed. The survival rate of patients was analyzed by Kaplan-Meier 's Log-rank test and multivariate analysis by Cox regression model. Results among 67 cases of HAVS, 59 cases were hepatic arterial-portal vein fistula, 8 cases were hepatic arterio-hepatic vein fistula, 53 cases were mild and moderate arteriovenous fistula, 14 cases were severe arteriovenous fistula. The complete embolization rate of moderate arteriovenous fistula was 73.6% (39 / 53) higher than that of severe arteriovenous fistula (35 / 14). The difference was statistically significant (蠂 ~ (2 / 2) 7.04% P ~ (0.008). Among 67 patients, there were 2 cases of complete remission of CRT, 29 cases of partial remission of PRN, 30 cases of stable SDD, 6 cases of PDD, and 6 cases of disease progression. The total effective rate was 46.7%. The 1 year survival rate was 49.3% in 67 patients with a median survival time of 11.0 months. Univariate analysis showed that the survival rate of tumor size was 8cm / 鈮，

本文編號：1830067