發(fā)布時間：2018-08-26 08:30

【摘要】：目的探討采用無水乙醇明膠海綿混合物(ESG)聯(lián)合化療藥物和/或碘化油,對合并中重度肝動脈門靜脈分流(APS)的肝癌(HCC)患者行末梢性化療栓塞的安全性和有效性。方法回顧性分析2008年6月至2015年12月使用ESG栓塞治療106例HCC合并中重度APS患者的臨床資料,對于手術(shù)前后APS改善情況、手術(shù)相關(guān)并發(fā)癥、腫瘤反應(yīng)、生存期和預(yù)后因素等進(jìn)行統(tǒng)計學(xué)分析。結(jié)果 106例HCC合并中重度APS的患者中位生存期為278 d,6、12、18個月累積生存率分別為70.8%、36.1%、16.0%。單因素分析結(jié)果顯示:性別、總膽紅素水平、最大腫瘤直徑、既往治療、治療有無應(yīng)答以及APS改善與患者預(yù)后相關(guān)。多因素分析結(jié)果顯示:治療有應(yīng)答、APS改善是獨(dú)立保護(hù)因素,而女性、最大腫瘤直徑≥5 cm為獨(dú)立危險因素。結(jié)論采用ESG栓塞治療合并中重度APS的HCC患者安全、有效,治療有應(yīng)答、APS改善患者預(yù)后較好,而女性、最大腫瘤直徑≥5 cm為患者預(yù)后危險因素。
[Abstract]:Objective to investigate the safety and efficacy of ethanol gelfoam mixture (ESG) combined with chemotherapeutic drugs and / or lipiodol in the treatment of hepatocellular carcinoma (HCC) with moderate and severe hepatic artery and portal vein shunt (APS). Methods from June 2008 to December 2015, the clinical data of 106 HCC patients with moderate and severe APS treated by ESG embolization were retrospectively analyzed. The improvement of APS before and after operation, surgical complications and tumor reaction were analyzed retrospectively. Survival time and prognostic factors were analyzed statistically. Results the median survival time of 106 patients with HCC combined with moderate and severe APS was 278d or 612.The cumulative survival rate of 18 months was 70.8 / 36.1 / 16.0, respectively. Univariate analysis showed that sex, total bilirubin level, maximum tumor diameter, past treatment, response to treatment and improvement of APS were associated with prognosis. The results of multivariate analysis showed that the improvement of response to APS was an independent protective factor, while in women, the maximum tumor diameter 鈮，

本文編號：2204298