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目的探讨影响中晚期肝癌患者介入治疗预后的危险因素,并制定相应的干预对策。方法回顾性分析120例行介入治疗术的中晚期肝癌患者的临床资料,记录患者一般资料、肝癌分期、术前及术后甲胎蛋白(AFP)变化情况、肿块类型及大小,治疗次数、术前合并症及术后并发症等,对可能因素进行初步的单因素统计分析,再用Logistic回归分析筛选有较大关联度的独立危险因素。结果 120例患者在介入治疗后肿瘤平均缩小率达75.0%以上。生存5年以上者23例。单因素统计结果表明,性别、临床Okuda分期、肝功能Child分期、术后AFP变化情况、肿块类型、肿块大小、门静脉癌栓、有无转移、治疗次数及术后并发症的处理情况等均为中晚期肝癌患者介入治疗预后的危险因素;Logistic多因素分析结果显示,肿瘤大小、术后AFP变化、门静脉癌栓和治疗方法为影响中晚期肝癌患者介入治疗预后的独立危险因素。结论中晚期肝癌患者介入术后的独立危险因素有肿瘤大小、术后AFP变化、门静脉癌栓和治疗方法等,应密切观察患者的各项指标,选择合适的治疗方法,积极处理术后并发症,以提高患者的生活质量,延长生存时间。
Objective To explore the risk factors influencing the prognosis of patients with advanced hepatocellular carcinoma after interventional therapy and to develop corresponding intervention strategies. Methods The clinical data of 120 patients with advanced hepatocellular carcinoma treated with interventional therapy were retrospectively analyzed. The general data, the staging of liver cancer, the changes of AFP, the type and size of the tumor, the number of treatment, Pre-comorbidities and postoperative complications, the possible factors for a preliminary single-factor statistical analysis, and then use Logistic regression analysis of screening associated with a greater risk of independent risk factors. Results The average reduction rate of tumor in 120 patients after interventional therapy was above 75.0%. 23 cases survived for more than 5 years. Univariate statistics showed that sex, clinical Okuda stage, liver function Child staging, postoperative AFP changes, tumor type, tumor size, portal vein tumor thrombus, with or without metastasis, the number of treatment and postoperative complications were Logistic multivariate analysis showed that tumor size, postoperative AFP changes, portal vein tumor thrombus and treatment were the independent risk factors influencing the prognosis of advanced hepatocellular carcinoma patients after interventional therapy. Conclusion The independent risk factors of advanced hepatocellular carcinoma after interventional therapy are tumor size, postoperative AFP changes, portal vein tumor thrombus and treatment methods, etc. All the indexes of patients should be closely observed, the appropriate treatment methods should be selected and the postoperative complications should be actively treated , To improve the quality of life of patients and prolong survival time.