本文選題：交聯(lián)葡聚糖凝膠微球顆粒 + 栓塞劑　； 參考：《第四軍醫(yī)大學》2015年碩士論文

【摘要】：目的:比較交聯(lián)葡聚糖凝膠微球顆粒栓塞劑和超液態(tài)碘化油栓塞劑對原發(fā)性肝癌的臨床療效,并對交聯(lián)葡聚糖凝膠微球顆粒栓塞劑的有效性、安全性做出評價。方法:選擇2012年1月至2013年1月入院治療的原發(fā)性肝癌患者24例,包括男性患者13例,平均年齡51.8±11歲,女性患者11例,平均年齡55.2±9.5歲。采用隨機雙盲對照研究,將24例確診為原發(fā)性肝癌患者分為交聯(lián)葡聚糖凝膠微球顆粒栓塞組和超液態(tài)碘化油栓塞組,兩組患者的年齡大小、術前瘤體面積,血清AFP陽性率等均無顯著差異(P0.05)。兩組患者經不同栓塞劑行TACE治療45天后,分別觀察其栓塞后瘤體縮小面積、肝功能、血常規(guī)、血清AFP水平、術后不良反應及生存率等指標變化情況,結合影像學評估交聯(lián)葡聚糖凝膠微球顆粒栓塞劑的安全性及其療效。結果:1.腫瘤縮小:研究組病灶完全緩解1例(占8.3%),部分緩解10例(占83.3%),穩(wěn)定1例(占8.3%),10例患者腫瘤區(qū)出現(xiàn)液性壞死區(qū)(占83.3%)。對照組中無完全緩解病例,部分緩解5例(占41.7%),穩(wěn)定3例(占25%),發(fā)展4例(占33.3%),3例患者腫瘤區(qū)出現(xiàn)液化壞死區(qū)(占25%)。相比對照組,研究組患者術后腫瘤顯著縮小(P0.05)。2.血清AFP水平下降:研究組有10例患者AFP降低,而對照組有9例,且研究組AFP下降值顯著高于對照組(P0.05)。3.術后不良反應及并發(fā)癥:研究組平均發(fā)熱天數(shù)(1.67 d)顯著少于對照組(2.91 d)(P0.05),而發(fā)熱人數(shù)卻顯著多于對照組(P0.05),研究組患者發(fā)生惡心或嘔吐人數(shù)以及疼痛/II級人數(shù)均顯著多于對照組(P0.05)。4.實驗室檢查:治療前后,兩組患者所有血清指標均無顯著性變化(P0.05)。5.栓塞后180天存活率:研究組患者生存率83.33%,平行對照組患者生存率66.67%,兩組均未發(fā)生嚴重不良反應。結論:交聯(lián)葡聚糖凝膠微球顆粒栓塞劑療肝癌安全有效,較超液態(tài)碘化油治療效更好,患者經濟負擔更輕,有較好的臨床治療價值。
[Abstract]:Objective: To compare the clinical efficacy of crosslinked dextran gel microsphere particle embolism agent and super liquid iodized oil embolic agent in the treatment of primary liver cancer, and evaluate the effectiveness and safety of the crosslinked dextran gel microsphere embolic agent. Methods: 24 cases of primary liver cancer, including male patients, were selected from January 2012 to January 2013, including male patients. In 13 cases, the average age was 51.8 + 11 years, and the average age of 11 women was 55.2 + 9.5 years old. A randomized double blind control study was used. 24 cases of primary liver cancer were divided into the cross linked dextran gel microsphere embolism group and the super liquid iodized oil embolism group. The age size of the two groups, the area of the tumor before operation, and the positive rate of the serum AFP were no longer in the two groups. Significant difference (P0.05). Two groups of patients were treated with different embolic agents for 45 days. After 45 days, the tumor size, liver function, blood routine, serum AFP level, postoperative adverse reaction and survival rate were observed, and the safety and efficacy of the crosslinked dextran gel microspheres were evaluated by imaging. Results: 1 Tumor reduction: 1 cases of complete remission in the study group (8.3%), partial remission in 10 cases (83.3%), 1 cases (8.3%), 10 patients with liquid necrotic area (83.3%). In the control group, there were no complete remission cases, 5 cases (41.7%), 3 cases (25%), 4 cases (occupy 25%), and liquefied necrotic areas in the tumor area. 25%). Compared with the control group, the tumor significantly reduced (P0.05).2. serum AFP level in the study group: in the study group, there were 10 patients with lower AFP and 9 in the control group, and the AFP descent value of the study group was significantly higher than that of the control group (P0.05).3. postoperative adverse reactions and complications: the average number of fever days (1.67 d) in the study group was significantly less than that of the control group (2.91 d) (2.91 d). P0.05), but the number of fever was significantly more than that of the control group (P0.05). The number of patients with nausea or vomiting and the number of pain /II levels in the study group were significantly more than that of the control group (P0.05).4. laboratory examination: before and after the treatment, all the serum indexes of the two groups had no significant changes (P0.05) the survival rate of the.5. after.5. embolism: the survival rate of the study group was 83.33%. The survival rate of the patients in the parallel control group was 66.67% and the two groups had no serious adverse reactions. Conclusion: the crosslinked dextran gel microsphere particle embolic agent is safe and effective in the treatment of liver cancer, which is better than the super liquid iodized oil, and the patient's economic burden is lighter and has a better clinical value.

【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.7

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1 岳琨;交聯(lián)葡聚糖凝膠栓塞劑肝癌栓塞治療安全性、有效性、隨機、平行對照研究[D];第四軍醫(yī)大學;2015年

2 王立暉;胃蛋白酶酶解酪蛋白制備酪啡肽的研究[D];西華大學;2006年

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