肝动脉栓塞化疗术对原发性肝癌伴 有不同类型肝炎后肝硬化患者预后的影响

目的:探讨肝动脉栓塞化疗(TACE)对原发性肝癌伴有不同肝炎后肝硬化类型患者术后肝功能、凝血功能及其对远期预后的影响。方法:2007年8月至2009年8月,131例曾行TACE的伴有不同肝炎后肝硬化原发性肝癌患者,以肝炎后肝硬化类别(乙肝、丙肝)分类,乙肝后肝硬化组为组1,丙肝后肝硬化组为组2,随访观察术后一年肝功能、凝血功能、血小板等的变化以及预后。两组研究因素采用SPSS17.0进行卡方检验,随访预后采用Kaplan-Meier方法计算生存率,Log-rank法检验生存差异。以P<0.05为差异有统计学意义。结果:随访统计结果显示术后半年和一年AST、ALT、ALP、GGT、PT、PLT在两组间均无统计学差异,(P>0.05);组一半年、一年远处转移率同组二差异间无统计学意义;组一半年、一年生存率分别为70.1%,48.1%;组二半年、一年生存率分别为68.5%,58.9%,两组间同期生存率差异无统计学意义。(X2=0.039,P=0.884;X2=0.183,P=0.669)。结论:TACE治疗PHC安全可靠,对于伴有乙肝或丙肝后肝硬化患者术后肝功能、凝血功能、疗效及预后效果相当。

Effects and Prognosis of Transcatheter Arterial Chemoembolization for Patients with Primary Hepatocellular Carcinoma Combining with Different type of Posthepatitic Cirrhosis

Objective: To evaluate the liver function,Coagulation Function and the effects of transcatheter aneria1 chemoembolization(TACE) on patients with primary hepatocellular carcinoma(PHC) combining with different type of posthepatitic cirrhosis.Methods: 131 patients diagnosed as primary hepatocellular carcinoma(PHC) combining with different type of posthepatitic cirrhosis by TACE in our department from August 2007 to August 2009 were included in this study.The patients were divided into two groups: these cases with(PHC) combining with liver cirrhosis with chronic hepatitis B in group1,liver cirrhosis with chronic hepatitis C in group 2.Follow-up 1 year for the clinical and laboratory data(include ALT,AST,GGT,ALP,PT,PLT) and the overall survival rates.Chi-square statistics,Kaplan-Meier and Log-rank method were used to determine factors and survival rates by SPSS17.0.Results: The statistics results by 1 year follow-up shows that there was no significant difference in AST,ALT,ALP,GGT,PT,PLT six months and one year after TACE(P>0.05);the distant metastasis rate of six months and 1 year has no significant difference in two groups(P>0.05),0.841).For group 1,six months and 1 year overall survival rates were 70.1%,48.1%,respectively,for group 2,they were 68.5%,58.9%,respectively.There was not significant difference in six months and 1 year survival rates between 2 groups(X2=0.039,P=0.884;X2=0.183,P=0.669).Conclusions: The efficacy of liver function,Coagulation Function and prognosis of TACE for PHC combining with liver cirrhosis with chronic hepatitis B or C were similar.