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目的观察并分析术后注射三氧化二砷(IVD)联合动脉化学栓塞(TACE)治疗原发性肝癌患者的疗效及安全性。方法随机选取2014年6月至2015年6月该院100例TACE术后原发性肝癌患者作为研究对象,分为对照组和试验组,每组50例。给予试验组患者TACE术后1~14d注射10mgIVD,连续4个循环和护理干预;给予对照组患者TACE术后注射生理盐水,通过比较治疗前后有效率、血清血管内皮生长因子(VEGF)、体力状况评分、生活质量、远期疗效以及药物不良反应观察两组患者的疗效。结果 (1)临床疗效:试验组客观有效率为34%,对照组为6%;疾病控制率或获益率试验组为74%,对照组为66%,比较差异均无统计学意义(P>0.05)。(2)血清VEGF:术后两组血清VEGF值升高,术后第3天、第8天两组血清VEGF值变动差异无统计学意义(P>0.05);术后第16天试验组血清VEGF值下降,对照组依旧升高,比较差异有统计学意义(P<0.05)。(3)两组体力状况评分差异无统计学意义(P>0.05),在躯体功能和生存质量自评总分方面高于对照组,差异有统计学意义(P<0.05);在症状不良反应、心理机制、社会适应能力方面差异无统计学意义(P>0.05)。(4)远期疗效:试验组无进展生存期为(240.29±34.35)d,1年生存率为80%;对照组无进展生存期以及1年生存率分别为(178.99±22.40)d和46%,比较差异无统计学意义(P>0.05)。(5)两组药物不良应均不严重且状况基本一样,差异无统计学意义(P>0.05)。结论 IVD联合TACE治疗有可能提高客观有效率、疾病控制率和无进展生存时间和年生存率,降低血清VEGF水平,改善患者躯体功能和生存质量自评总分,但不能改善患者生活质量和体能状况评分。
Objective To observe and analyze the efficacy and safety of postoperative injection of arsenic trioxide (IVD) combined with arterial chemoembolization (TACE) in patients with primary liver cancer. Methods A total of 100 patients with primary hepatocellular carcinoma after TACE from June 2014 to June 2015 were randomly divided into control group and trial group, 50 cases in each group. Patients in the test group were injected with 10 mg of IVD for 1 ~ 14 days after TACE, and the rats in the control group were injected with normal saline after TACE for 4 consecutive cycles. Nursing patients in control group were given normal saline by comparing the effective rate, serum VEGF, Score, quality of life, long-term efficacy and adverse drug reactions observed in two groups of patients. Results (1) Clinical curative effect: The objective effective rate was 34% in the experimental group and 6% in the control group. The rate of disease control or benefit was 74% in the experimental group and 66% in the control group, with no significant difference (P > 0.05). (2) Serum VEGF: After the operation, serum VEGF increased in both groups. There was no significant difference in serum VEGF between the two groups on the third day and the eighth day after operation (P> 0.05) VEGF value decreased, the control group still increased, the difference was statistically significant (P <0.05). (3) There was no significant difference in physical status score between the two groups (P> 0.05), but higher in physical function and quality of life score than in control group (P <0.05) There was no significant difference in psychological mechanism and social adaptability (P> 0.05). (4) Long-term efficacy: The progression-free survival rate was (240.29 ± 34.35) days in the experimental group and 80% in the 1-year group. The progression-free survival rate and 1-year survival rate in the control group were (178.99 ± 22.40) d and 46 %, The difference was not statistically significant (P> 0.05). (5) The two groups of drug should not be serious and the situation is basically the same, the difference was not statistically significant (P> 0.05). Conclusions IVD combined with TACE may improve objective efficiency, disease control rate, progression-free survival time and annual survival rate, decrease serum VEGF level and improve physical function and quality of life self-rated score, but can not improve patients’ quality of life and physical fitness Condition score.