【摘要】：目的開展中央型肝細(xì)胞肝癌聯(lián)合術(shù)中瘤床放療技術(shù),并初步探索其安全性及臨床效果。方法將行開腹手術(shù)的79例中央型肝細(xì)胞肝癌患者分為實(shí)驗(yàn)組(聯(lián)合術(shù)中瘤床放療組,32例)和對(duì)照組(單純手術(shù)組,47例)。實(shí)驗(yàn)組患者手術(shù)切除腫瘤后,于瘤床行術(shù)中電子線放療,對(duì)照組無術(shù)中電子線放療步驟。比較兩組患者的術(shù)中、術(shù)后情況。結(jié)果兩組術(shù)后30天內(nèi)均無死亡病例。實(shí)驗(yàn)組患者的平均手術(shù)時(shí)間(319±76 min)長(zhǎng)于對(duì)照組(233±76 min,P=0.000),實(shí)驗(yàn)組患者術(shù)后第1天中位AST水平(562.5U/L)高于對(duì)照組(347 U/L,P=0.031),實(shí)驗(yàn)組術(shù)后第3天、第7天平均 PTA 水平低于對(duì)照組(68.3±17.9%和 78.9±15.9%,P=0.007;73.4±10.2%和80±10.6,P=0.007)。兩組患者腫瘤病理情況(分化程度、衛(wèi)星灶、被膜侵犯、微血管侵犯)的差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。兩組患者術(shù)后住院時(shí)間、肝功能不全、大量腹水、胸腔積液、感染、膽瘺、腸道通氣時(shí)間的差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。兩組患者術(shù)后第1、3、5、7天反映肝功能的其他實(shí)驗(yàn)室指標(biāo)(ALT、TBIL、ALB)的差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論聯(lián)合術(shù)中瘤床放療技術(shù)增長(zhǎng)了手術(shù)時(shí)間,減慢術(shù)后肝功能早期恢復(fù),但仍是安全可行的。
[Abstract]:Objective to develop the tumor bed radiotherapy for the combined operation of central hepatocellular carcinoma (HCC), and to explore its safety and clinical effect. Methods 79 patients with central hepatocellular carcinoma were divided into experimental group (combined intraoperative tumor radiotherapy group, 32 cases) and control group (47 cases). The patients in the two groups had no death in 30 days after operation. The average operating time (319 + 76 min) in the experimental group was longer than that of the control group (233 + 76 min, P=0.000), and the level of AST (562.5U/L) was high at first days after operation in the experimental group. In the control group (347 U/L, P=0.031), the average PTA level of the experimental group was lower than that of the control group (68.3 + 17.9% and 78.9 + 15.9%, P=0.007, 73.4 + 10.2% and 80 + 10.6, P=0.007). There was no significant difference between the tumor pathological conditions (the degree of differentiation, the satellite, the membrane invasion, the microvascular invasion) in the two group (all P0.05). There was no significant difference in the time of hospitalization, liver dysfunction, massive ascites, pleural effusion, infection, biliary fistula, and intestinal ventilation time (all P0.05). There was no significant difference between the two groups of other laboratory indexes (ALT, TBIL, ALB) that reflected the liver function on day 1,3,5,7 after operation (all P0.05). Conclusion the combination of tumor bed radiotherapy technique in the combined operation The operation time and the early recovery of liver function after operation were slowed down, but it was still safe and feasible.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【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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