中国肿瘤临床与康复

目的探讨微创介入手术在原发性肝癌患者中的应用效果及预后影响因素。方法选取2014年1月至2017年2月间汉川市人民医院收治的118例行微创介入治疗的原发性肝癌患者,按治疗方法不同分为经肝动脉化疗的A组(TAI组)42例、选择性肝动脉化疗栓塞的B组(TACE组)46例和经皮肝穿刺瘤内注射无水乙醇的C组(TACE+PEI组)30例。分析患者临床相关资料及生存率情况,探究微创介入手术的应用效果及预后影响因素。结果治疗后3年,C组患者生存率(76.7%)高于A组(26.2%)和B组(54.3%),差异均有统计学意义(均P<0.05)。经单因素分析显示,病理分型、肝功能分级和门静脉有无瘤栓下累积均是影响患者预后的主要因素。结论微创介入在原发性肝癌患者中应用效果较优,及时查找影响预后的主要因素,可提高患者生存率。

Objective To study and analyze the application of minimally invasive intervention in patients with primary liver cancer and factors influencing prognosis. Methods From January 2014 to February 2017,118 patients with primary liver cancer undergoing minimally invasive intervention at People's Hospital of Hanchuan were selected. According to different treatment methods,patients were divided into transcatheter arterial infusion( TAI) group( group A,42 patients). There were 46 patients in transarterial chemoembolization( TACE) group( group B,46 patients) and TACE plus percutaneous ethanol injection( PEI) group( group C,30 patients). The clinical data and survival was analyzed. The efficacy of minimally invasive intervention and and factors influencing prognosis were explored. Results At 3 years,the survival rate was significantly higher in group C( 76. 7%) than in group A( 26. 2%) and group B( 54. 3%)( all P < 0. 05). Univariate analysis revealed that pathological type,liver function grade,and with or without accumulation under plugs for portal vein tumor are major factors influencing prognosis. Conclusion The efficacy of minimally invasive intervention in patients with primary liver cancer is superior. Finding out the main factors influencing the prognosis in time is the key to improve the survival rate.