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目的 评价经导管肝动脉化疗栓塞术 (TACE)及部分脾栓塞术 (PSE)联合治疗对肝癌 (HCC)患者的肝功能及微循环状态的影响。方法 56例确诊为原发性肝癌患者 ,经TACE及PSE联合治疗 ,观察肝功指标变化及通过ChildPugh评分评价基础肝功能状态 ;用血液分析系统及微循环显微镜检测微循环状态 ;观察患者生存期。结果 术前患者的ChildPugh评分为 5 .40± 1 .1 2 ,联合治疗后 3d、1周、2周和 4周ChildPugh评分均有升高 ,分别为 6 .89± 1 .40、6 .64± 1 .38、6 .45± 1 .50和 5 .93± 1 .58,与术前比较均有显著性差异 (Ρ <0 .0 5)。联合介入治疗后全血低切粘度增加 (Ρ <0 .0 5) ,血浆粘度增加 (Ρ <0 .0 5) ,治疗后田牛氏加权积分增加 (P <0 .0 1 )。 6、1 2、2 4个月生存率分别为 83 .5 %、63 .3 %、45 .4 %。结论 对于肝癌患者 ,TACE及PSE联合治疗是有效的治疗方法 ,可以延长患者生存期 ,但也能加重肝功能损害及微循环障碍
Objective To evaluate the effects of combined transcatheter arterial chemoembolization (TACE) and partial splenic embolization (PSE) on hepatic function and microcirculation in patients with hepatocellular carcinoma (HCC). Methods Fifty-six patients with primary liver cancer were diagnosed as primary hepatocellular carcinoma (HCC). TACE and PSE were used to observe the changes of liver function indexes and to evaluate the basic liver function status by ChildPugh score. The blood circulation analysis system and microcirculation microscope were used to detect the state of microcirculation. . Results The Pre-Patient’s ChildPugh score was 5.40 ± 1.12, and the ChildPugh scores were increased at 3d, 1th, 2th and 4th weeks after the combination therapy, which were respectively 6.89 ± 1.40,6.64 ± 1.38, 6.45 ± 1.50 and 5.93 ± 1.58, respectively, which were significantly different from those before operation (P <0.05). After interventional treatment, the whole blood low cut viscosity increased (P <0.05), the plasma viscosity increased (P <0.05), and the latter increased (P <0.01). 6,1,2 4-month survival rates were 83.5%, 63.3%, 45.4%. Conclusion For patients with liver cancer, TACE and PSE combined treatment is an effective treatment that can prolong the survival of patients, but can also aggravate liver dysfunction and microcirculation