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目的 探讨中晚期原发性肝癌的肝动脉插管化疗、栓塞的疗效和经济价值。方法 无外科手术指征而有介入化疗适应证的 98例原发性肝癌患者 ,按是否行介入治疗分为 :介入组 45例 ,非介入组 5 3例 ,比较两组的临床疗效与成本 效果。结果 介入组 6个月、1年、2年和 3年生存率分别为 75 .6 %、5 5 .6 %、2 8.9%和 13 .3 % ,较非介入组的41.5 %、7.5 %、1.9%和 0 % ,生存期明显延长。行 1次介入治疗的平均总诊治费用为 92 0 2元 ;非介入组为 4977元 ;介入组中 2～ 3次治疗的上述各期生存率为 84.2 %、73 .7%、36 .8%和 15 .8% ,与行 4～ 6次治疗的 10 0 %、77.8%、44.4%和 2 2 .2 %比较 ,无显著统计学差异 (P >0 .0 5 ) ,而平均总费用分别为 2 0 2 0 7元和 35 476元。对各组进行平均总费用 /平均生存期的增量分析 ,2～ 3次介入的不良反应不多 ,合并症无加重 ,费用增加不明显 ,但生存期明显延长。结论 原发性肝癌经肝动脉插管化疗、栓塞是安全、有效的 ,可明显提高生存率。从经济学角度看 ,2～ 3次介入治疗的成本 效果较好。
Objective To investigate the efficacy and economic value of hepatic arterial intubation chemotherapy and embolization for advanced primary liver cancer. Methods There were 98 patients with primary liver cancer who had no indications for surgery and had indications for interventional chemotherapy. According to whether or not interventional therapy was performed, they were divided into interventional group (45 cases) and non-invasive group (53 cases). Clinical efficacy and cost effectiveness were compared between the two groups. . Results The survival rates at 6 months, 1 year, 2 years and 3 years in the intervention group were 75.6 %, 55.6 %, 28.9 % and 13.3 %, respectively, compared with 41.5 % and 7.5% of the non-invasive group. 1.9% and 0%, the survival time was significantly longer. The average total diagnosis and treatment cost for one interventional treatment was 920.2 yuan; for the non-invasive group, it was 4,977 yuan; the survival rate for the above-mentioned phases in the intervention group was 24.2%, 73.7%, 36.8%, respectively. And 15.8%, compared with 10%, 77.8%, 44.4% and 22.2% of 4 to 6 treatments, there was no significant difference (P > 0.05) and the average total cost was It is 2 0 2 7 yuan and 35 476 yuan. For the incremental analysis of the average total cost/average survival time for each group, there were not many adverse reactions from 2 to 3 interventions, no complications were aggravated, and the cost did not increase significantly, but the survival period was significantly longer. Conclusions Hepatic arterial intubation chemotherapy and embolization are safe and effective for primary liver cancer, which can significantly improve the survival rate. From the perspective of economics, the cost of 2 to 3 interventions is better.