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目的:探讨精准肝切除术联合肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PLC)的疗效及安全性。方法:选取2010年2月至2015年2月新疆阿克苏地区第一人民医院收治的62例PLC患者,按随机数字表法分为对照组与观察组,每组31例。对照组采用精准肝切除术治疗,观察组在此基础上术后给予TACE治疗,比较两组治疗前、后肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]及血清肿瘤标记物[癌胚抗原(CEA)、甲胎蛋白(AFP)]水平差异,并对患者进行2年的随访,观察患者预后生存情况以及术后并发症发生情况。结果:治疗后,两组ALT、AST、TBIL水平比较,差异均无统计学意义(均P>0.05),血清CEA和AFP均显著降低(均P<0.05),且观察组血清CEA和AFP水平均显著低于对照组(均P<0.05)。观察组肿瘤复发率显著低于对照组(P<0.05),病灶清除率、1年生存率及2年生存率均显著高于对照组(均P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:精准肝切除术联合TACE治疗PLC,可充分发挥优势互补,更为有效控制肿瘤复发,改善患者预后生存,安全可靠。
Objective: To investigate the efficacy and safety of precision hepatectomy combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer (PLC). METHODS: A total of 62 PLC patients admitted to the First People’s Hospital of Aksu Prefecture from February 2010 to February 2015 were selected and divided into a control group and an observation group according to the random number table method. There were 31 cases in each group. The control group was treated with precision hepatectomy. The observation group was treated with TACE on postoperative basis. The liver function indexes before and after treatment were compared between the two groups (alanine aminotransferase (ALT), aspartate aminotransferase (AST), total Differences in levels of bilirubin (TBIL) and serum tumor markers [carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP)], follow-up of patients for 2 years, observation of survival and postoperative complications Happening. Results: After treatment, there was no significant difference in ALT, AST and TBIL levels between the two groups (all P>0.05). Serum CEA and AFP were significantly lower (all P<0.05). Serum CEA and AFP levels were also observed in the observation group. All were significantly lower than the control group (all P<0.05). The tumor recurrence rate in the observation group was significantly lower than that in the control group (P<0.05). The lesion clearance rate, one-year survival rate, and two-year survival rate were significantly higher than those in the control group (all P<0.05); the incidence of postoperative complications in the two groups The difference was not statistically significant (P>0.05). Conclusion: Precise hepatectomy combined with TACE in the treatment of PLC can give full play to their advantages and complement each other. It can effectively control the recurrence of tumors and improve the survival and prognosis of patients. It is safe and reliable.