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目的探讨减少原发性肝癌手术癌残存的方法。方法分组对照研究199例能一期手术切除的原发性肝癌。研究组68例术前、术后均予肝动脉化疗碘油栓塞(LP-TACE)治疗,对照组131例术后予LP-TACE治疗。分别统计2组常规CT、手术病理的子灶数,以及研究组手术切除前LP-TACE及碘油栓塞后CT扫描(LP-CT)的子灶数,统计2组术后癌残存率及残存癌灶数,予t及χ2检验,研究术前TACE与手术癌残存的关系。结果研究组术前LP-TACE并LP-CT使子灶的发现率较常规CT提高了21.50%,前后相比较,P<0.05,具显著性差异;研究组与对照组相比较常规CT子灶均数及子灶敏感率,t=0.075,χ2=2.545,P>0.05,无显著性差异;手术癌残存率研究组为27.94%,对照组为46.56%,2组相比较,P<0.05,具显著性差异。结论原发性肝癌术前LP-TACE治疗,对发现肝内微小病灶,降低手术癌残存具有重要意义。
Objective To explore ways to reduce the residual surgical treatment of primary liver cancer. Methods Group controlled study of 199 cases of primary liver cancer resection. Sixty-eight cases in the study group were treated with LP-TACE before and after the operation in the study group, 131 cases in the control group were treated with LP-TACE after operation. The CT counts of two groups of conventional CT, the number of lesions in the pathology and the number of lesions in the study group after LP-TACE and LP-CT before the resection of the lipiodol group were calculated respectively. The postoperative residual cancer rate and residual The number of foci, to t and χ2 test to study the relationship between preoperative TACE and surgical residual. Results The preoperative LP-TACE and LP-CT in the study group increased the detection rate of sub-focus by 21.50% compared with that of conventional CT, and there was significant difference between before and after treatment (P <0.05). Compared with the control group, There was no significant difference between the two groups (t = 0.075, χ2 = 2.545, P> 0.05). The survival rate of surgical resection was 27.94% in the study group and 46.56% in the control group, P <0.05, A significant difference. Conclusion Preoperative LP-TACE treatment of primary liver cancer is of great significance for the discovery of small intrahepatic lesions and reduction of residual cancer.