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目的观察生物微球联合碘油经肝动脉栓塞化疗(TACE)治疗不能手术切除的原发性肝癌患者的临床疗效。方法选择本院2010年1月至2012年12月40例行选择性肝动脉栓塞化疗时使用生物微球联合碘油栓塞化疗的原发性肝癌患者和42例行选择性肝动脉栓塞时使用碘油栓塞化疗的患者,每例行栓塞术4次以上,于首次术后1、3、6、12和24 m随访生存患者肝功能、甲胎蛋白、腹部增强CT等变化,比较治疗后病灶缩小程度,观察肿瘤部分缓解率及患者生存率。结果在首次术后3个月时,微球联合组肿瘤缓解率为(57.44%),明显高于TACE组[(45.23%),P<0.05],6个月时微球联合组AFP为(296.7±96.3)ng/ml,明显低于TACE组[(346.9±118.3)ng/ml,P<0.05],12个月时微球联合组肿瘤直径为(3.36±1.37)cm,明显低于TACE组[(4.98±1.87)cm,P<0.05],24个月时微球联合组生存率为(15.0%),明显高于TACE组[(2.3%),P<0.05]。结论生物微球联合碘油栓塞化疗治疗患者病灶缩小程度、AFP下降水平、肿瘤部分缓解率及患者生存率明显高于单纯碘油栓塞化疗组,生物微球联合碘油栓塞化疗治疗中晚期原发性肝癌疗效确切,临床疗效优于单纯栓塞化疗,且安全可行。
Objective To observe the clinical effect of bio-microspheres combined with lipiodol in patients with unresectable primary liver cancer treated by transcatheter arterial chemoembolization (TACE). Methods From January 2010 to December 2012, 40 patients with primary hepatic carcinoma undergoing selective hepatic arterial chemoembolization with biomagnetic beads and lipiodol embolization and 42 patients with selective hepatic artery embolization using iodine In patients undergoing oil embolization and chemotherapy, with embolization of more than 4 times per patient, the liver function, alpha-fetoprotein and abdominal enhanced CT were followed up at 1, 3, 6, 12 and 24 m after the first postoperation. Extent, observe the partial tumor remission rate and patient survival rate. Results The remission rate of microspheres combined group was 57.44% at 3 months after the first operation, which was significantly higher than that in TACE group (45.23%, P <0.05). At 6 months, the AFP in microsphere combined group was ( 296.7 ± 96.3) ng / ml, which was significantly lower than that of TACE group [(346.9 ± 118.3) ng / ml, P <0.05] Group [(4.98 ± 1.87) cm, P <0.05]. At 24 months, the survival rate of microsphere combined group was 15.0%, significantly higher than that of TACE group (2.3%, P <0.05). Conclusions The reduction of the lesion, the decrease of AFP, the partial remission rate of tumor and the survival rate of patients with bio-microsphere combined with lipiodol embolization and chemotherapy are obviously higher than those of simple lipiodol embolization chemotherapy group and bio-microsphere combined with lipiodol embolization chemotherapy in the treatment of middle- Efficacy of liver cancer is accurate, clinical efficacy is superior to simple embolization chemotherapy, and safe and feasible.