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目的探究经肝动脉化疗栓塞术(TACE)联合射频消融(RFA)治疗初发性及复发性肝癌的疗效及预后影响因素。方法抽取2012年6月-2014年10月我院收治的78例肝癌患者,将初发性肝癌患者作为对照组,复发性肝癌患者作为研究组,各39例。两组均采用TACE+RFA治疗,术后随访2年。统计两组临床疗效、不同随访时间(第6、12、24个月)生存率,对比治疗前后Child-Pugh评分变化情况,并分析预后影响因素。结果研究组治疗有效率(82.05%)与对照组(87.18%)对比,差异无统计学意义(P>0.05)。治疗前两组Child-Pugh评分对比差异无统计学意义(P>0.05);治疗后两组Child-Pugh评分均较治疗前有所降低,且组间对比差异无统计学意义(P>0.05)。研究组术后第6、12、24个月生存率(92.31%、79.49%、61.54%)与对照组(92.31%、76.92%、66.67%)对比差异无统计学意义(P>0.05)。合并门静脉侧支循环、Child-Pugh分级、AFP及总胆红素均为肝癌患者预后影响因素。结论联合采用TACE与射频消融治疗初发性及复发性肝癌均可取得显著疗效,改善患者肝功能,提高生存率,且合并门静脉侧支循环、Child-Pugh分级、AFP及总胆红素均为肝癌患者预后影响因素。
Objective To investigate the efficacy and prognostic factors of primary and recurrent hepatocellular carcinoma treated by transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA). Methods Totally 78 patients with HCC who were admitted to our hospital from June 2012 to October 2014 were selected as the control group and 39 patients with recurrent HCC as study group. Both groups were treated with TACE + RFA, followed up for 2 years. The clinical curative effect, survival rate at different follow-up time (6th, 12th and 24th months) were compared. The changes of Child-Pugh score before and after treatment were compared and the prognostic factors were analyzed. Results There was no significant difference between the two groups in the treatment efficiency (82.05%) and the control group (87.18%) (P> 0.05). There was no significant difference in Child-Pugh scores between the two groups before treatment (P> 0.05). Child-Pugh scores of both groups were lower than before treatment, and there was no significant difference between the two groups (P> 0.05) . The survival rates of the study group at 6, 12, and 24 months after operation were 92.31%, 79.49% and 61.54% respectively. There was no significant difference between the two groups (92.31%, 76.92%, 66.67%) in the control group (P> 0.05). Merged portal vein collateral circulation, Child-Pugh classification, AFP and total bilirubin were prognostic factors in patients with liver cancer. Conclusions TACE and radiofrequency ablation combined with TACE and radiofrequency ablation can achieve a significant effect on primary liver cancer and recurrent hepatocellular carcinoma, improve liver function and improve survival rate. Combined with portal vein collateral circulation, Child-Pugh classification, AFP and total bilirubin Prognostic factors of liver cancer patients.