碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌的临床效果

目的:探讨碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌的临床效果及安全性。方法:选择2015年2月到2018年6月在我院诊治的中晚期肝癌患者78例,根据随机数字表法将其均分为两组,每组各39例。对照组给予载药微球经肝动脉化疗栓塞治疗,实验组给予碳酸氢钠+载药微球经肝动脉化疗栓塞治疗,比较两组的临床疗效,治疗前后CD3~+CD4~+、CD3~+CD8~+T细胞比例的变化,治疗期间不良反应的发生情况及预后。结果:治疗后,实验组与对照组的治疗总有效率分别为74.4%和43.6%,实验组显著高于对照组(P0.05)。实验组治疗期间的发热、腹痛、腹胀、呕吐等不良反应发生情况与对照组的对比差异无统计学意义(P0.05)。两组治疗前后CD3CD4~+T比例对比差异无统计学意义(P0.05),两组治疗后的CD3~+CD8~+T比例显著低于治疗前,且实验组明显低于对照组(P0.05)。治疗后,实验组的躯体功能、心理功能、社会功能、共性症状及副作用评分都低于对照组(P0.05)。结论:碳酸氢钠+载药微球经肝动脉化疗栓塞治疗中晚期肝癌能提高治疗效果,改善机体的免疫功能,提高患者的生活质量,且不会增加不良反应。

Effects of Sodium Bicarbonate + drug-loaded Microspheres in the Treatment of Advanced Hepatocellular Carcinoma by Transcatheter Arterial Chemoembolization

ABSTRACT Objective: To investigate the clinical efficacy and safety of sodium bicarbonate+drug-loaded microspheres in the treatment of advanced hepatocellular carcinoma by transcatheter arterial chemoembolization. Methods: 78 patients with advanced hepatocellular carcinoma who were treated in a certain hospital from February 2015 to June 2018 were selected and were equally divided into the experimental group and control group accorded to the random number table method. There were 39 cases in each group. The control group were treated with transcatheter arterial chemoembolization, the experimental group were treated with sodium bicarbonate and drug-loaded microspheres via transcatheter arterial chemoembolization. These indexes were compared in the two groups which include the clinical efficacy, the changes of CD3⁺CD4⁺, CD3⁺CD8⁺ T cell ratio before and after treatment, the occurrence of adverse reactions and prognosis during treatment. Results: After treatment, the total effective rates of the experimental group and the control group were 74.4% and 43.6%, respectively, and the experimental group were significantly higher than the control group (P<0.05). There were no significant difference in the incidence of adverse reactions such as fever, abdominal pain, bloating, vomiting and the control group during the treatment group (P>0.05). There were no significant difference in the proportion of CD3⁺CD4⁺T between the two groups before and after treatment (P>0.05), and the proportion of CD3⁺CD8⁺T after treatment were significantly lower than that before treatment in the two group (P<0.05), and the experimental group were significantly lower than the control group (P<0.05). After treatment, the physical function, psychological function, social function, common symptoms and side effects of the experimental group were lower than the control group (P<0.05). Conclusion: The treatment of sodium bicarbonate + drug-loaded microspheres by transcatheter arterial chemoembolization can improve therapeutic effect, immune function of the body and the quality of life of patients, and no increase adverse reactions in advanced hepatocellular carcinoma.