CAJ | 학술논문

目的探讨肝动脉化疗栓塞术(TACE)后肝区疼痛与近期疗效的关系.方法 118例原发性肝癌患者按照TACE术后肝区疼痛程度分为两组,A组无明显肝区疼痛,B组有明显肝区疼痛,比较两组病灶在首次介入治疗后的反应,分析TACE后肝区疼痛的相关因素.结果首次介入术后4～6周行CT检查,按RECIST标准评价疗效,A、B两组CR、PR、SD、PD分别为0、1.45%、88.41%、10.14%和0、14.29%、81.63%、4.08%,有效率OR(CR+PR)比较差异有统计学意义(P=0.0087).分析术后疼痛原因可能与术前病灶血供、包膜、肝硬化和术后病灶碘油充填类型有关,其中碘油沉积分型与疼痛分级呈负相关(r=-0.539,P＜0.01).结论介入术后肝区疼痛多提示患者肿瘤栓塞效果好、预后好.充分认识TACE后肝区疼痛与疗效相关性具有重要临床意义.
목적 탐토간동맥화료전새술(TACE)후간구동통여근기료효적관계.방법 118례원발성간암환자안조TACE술후간구동통정도분위량조,A조무명현간구동통,B조유명현간구동통,비교량조병조재수차개입치료후적반응,분석TACE후간구동통적상관인소.결과 수차개입술후4～6주행CT검사,안RECIST표준평개료효,A、B량조CR、PR、SD、PD분별위0、1.45%、88.41%、10.14%화0、14.29%、81.63%、4.08%,유효솔OR(CR+PR)비교차이유통계학의의(P=0.0087).분석술후동통원인가능여술전병조혈공、포막、간경화화술후병조전유충전류형유관,기중전유침적분형여동통분급정부상관(r=-0.539,P＜0.01).결론 개입술후간구동통다제시환자종류전새효과호、예후호.충분인식TACE후간구동통여료효상관성구유중요림상의의.
Objective To investigate the relationship between the liver pain and the short-term curative effect in patients with primary hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE).Methods According to the degree of liver pain,118 HCC patients after the initial TACE treatment were divided into two groups:group A(with no complaint of serious liver pain)and group B (complaining of severe liver pain).Short-term curative effects at the fourth and sixth week after initial TACE were compared between the two groups,and the factors related to the liver pain after TACE were analyzed.Results Four to six weeks after the initial TACE,CT scan was performed in all patients.Based on the RECIST criteria the short-term curative effects were evaluated.The CR,PR,SD,PD of group A and B were 0%.1.45%.88.41%,10.14%and 0%,14.29%.81.63%,4.08%,respectively.The difference in OR(CR +PR)between two groups was statistically significant(P=0.0087).The postoperative liver pain was probably related to the preoperative tumor blood supply pattern,the tumor capsule.the cirrhosis and the type of iodized oil deposit.The type of iodized oil deposit showed a negative correlation with the grade of liver pain (r=-0.539,P＜0.001).Conclusion The liver pain occurred after TACE is a useful suggestive sign,which indicates that a good curative result will be obtained.It is of clinical significance to make a full understanding of the relationship between the liver pain and the therapeutic effect.