肝动脉化疗栓塞介入术对原发性肝癌患者近期疗效及Child-Pugh分级的影响

王瑞航 姚升娟 张晨

摘要：目的  探讨肝动脉化疗栓塞介入术（TACE）对原发性肝癌患者近期疗效及Child-Pugh分级的影响。方法  收集我院2018年9月～2019年7月收治的95例原发性肝癌患者临床资料，根据其治疗方式分为对照组（n=46）与观察组（n=49）。对照组行射频消融术治疗，观察组行TACE治疗，比较两组近期疗效、Child-Pugh分级及不良反应总发生率。结果  观察组总有效率高于对照组，Child-Pugh分级优于对照组，差异有统计学意义（P<0.05）;两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论  原发性肝癌患者应用TACE治疗近期疗效较佳，可有效改善Child-Pugh分级，且安全性高，不良反应少。

关键词：原发性肝癌;肝动脉化疗栓塞介入术;陀螺刀放射;近期疗效;Child-Pugh分级

中图分类号：R735.7                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.17.029

文章编号：1006-1959（2020）17-0101-02

Abstract：Objective  To explore the effect of hepatic artery chemoembolization intervention （TACE） on the short-term curative effect and Child-Pugh classification of patients with primary liver cancer.Methods  The clinical data of 95 patients with primary liver cancer admitted in our hospital from September 2018 to July 2019 were collected and divided into control group （n=46） and observation group （n=49） according to their treatment methods. The control group was treated with radiofrequency ablation， and the observation group was treated with TACE. The short-term curative effect， Child-Pugh classification and total incidence of adverse reactions were compared between the two groups. Results  The total effective rate of the observation group was higher than that of the control group， and the Child-Pugh classification was better than that of the control group，the difference was statistically significant （P<0.05）; the total incidence of adverse reactions between the two groups was not statistically significant （P>0.05）.Conclusion  TACE treatment for patients with primary liver cancer has better short-term curative effect， can effectively improve Child-Pugh classification， and has high safety and few adverse reactions.

Key words：Primary liver cancer;Hepatic artery chemoembolization intervention;Gyro knife radiation;Short-term efficacy;Child-Pugh classification

原發性肝癌（primary liver cancer）具有病情隐匿、病情发展缓慢等特点，大部分患者察觉就诊时病情已处于中晚期，丧失最佳手术时机[1]。既往临床针对中晚期原发性肝癌多采用化疗药物治疗，其虽具有良好抑制作用，但毒副反应较多，患者耐受度较差，故应用存在较强局限性。随着介入治疗技术的发展，肝动脉化疗栓塞介入术（TACE）逐步应用于原发性肝癌治疗中，其通过将化疗药物灌注于肿瘤供血动脉内，以促使肿瘤细胞缺血坏死，具有良好应用效果[2]。但目前临床对其治疗近期疗效及对Child-Pugh分级报道较少，鉴于此，本研究旨在探讨TACE对原发性肝癌患者近期疗效及Child-Pugh分级的影响，现报道如下。

1资料与方法

1.1 一般资料  收集天津市第二人民医院2018年9月～2019年7月收治的95例原发性肝癌患者临床资料，根据其治疗方式分为对照组（n=46）与观察组（n=49）。对照组男29例，女17例;年龄46～68岁，平均年龄（57.48±4.32）岁;肝功能Child-Pugh分级：A级22例，B级24例;单发肿瘤34例，多发肿瘤12例。观察组男31例，女18例;年龄46～67岁，平均年龄（57.86±4.58）岁;其中依据肝功能Child-Pugh分级标准：A级23例，B级26例;单发肿瘤36例，多发肿瘤13例。两组性别、年龄及Child-Pugh分级比较，差异无统计学意义（P>0.05），研究具有可对比性。