CAJ | 학술논문

目的：探讨肝动脉灌注化疗栓塞术（ TACE）联合射频消融术（ RFA）治疗肝癌（ HCC）的疗效与安全性。方法按照随机分组的方法将114例HCC患者分为观察组和对照组，各57例。对照组接受TACE治疗，观察组于TACE治疗后2～3周后在DSA引导下行RFA治疗。比较2组治疗前及治疗后12个月的AFP值及肿瘤体积，比较2组治疗后肿瘤完全坏死率及治疗总有效率，随访1年、2年及3年生存率并统计分析不良反应发生情况。结果2组患者均能耐受治疗，治疗后AFP值及肿瘤体积变化与治疗前比较均有改善（P＜0．05）。观察组治疗后12个月AFP值及肿瘤体积变化均优于对照组，2组比较差异有统计学意义（ P＜0．05）；观察组肿瘤完全坏死率及治疗总有效率均优于对照组，2组比较差异有统计学意义（ P＜0．05）；观察组1年、2年及3年随访生存率均高于对照组，2组比较差异均有统计学意义（ P＜0．05）。结论 TACE联合RFA术治疗HCC可提高患者的治疗有效率、肿瘤完全坏死率，控制肿瘤病灶，延长患者的生存期，具有较高的临床应用价值。
목적：탐토간동맥관주화료전새술（ TACE）연합사빈소융술（ RFA）치료간암（ HCC）적료효여안전성。방법안조수궤분조적방법장114례HCC환자분위관찰조화대조조，각57례。대조조접수TACE치료，관찰조우TACE치료후2～3주후재DSA인도하행RFA치료。비교2조치료전급치료후12개월적AFP치급종류체적，비교2조치료후종류완전배사솔급치료총유효솔，수방1년、2년급3년생존솔병통계분석불량반응발생정황。결과2조환자균능내수치료，치료후AFP치급종류체적변화여치료전비교균유개선（P＜0．05）。관찰조치료후12개월AFP치급종류체적변화균우우대조조，2조비교차이유통계학의의（ P＜0．05）；관찰조종류완전배사솔급치료총유효솔균우우대조조，2조비교차이유통계학의의（ P＜0．05）；관찰조1년、2년급3년수방생존솔균고우대조조，2조비교차이균유통계학의의（ P＜0．05）。결론 TACE연합RFA술치료HCC가제고환자적치료유효솔、종류완전배사솔，공제종류병조，연장환자적생존기，구유교고적림상응용개치。
Objective To study the efficacy and safety of transcatheter arterial chemoembolization ( TACE) combined with radiofrequency ablation ( RFA) for hepatocellular carcinoma ( HCC) .Methods 114 HCC patients were randomly divided into the observation group and the control group.The control group received TACE and the observation group received RFA com-bined with TACE through digital subtraction angiography.The alpha fetoprotein ( AFP) ,tumor volume,rate of complete necrosis of tumor and total effective rate of the 2 groups were compared.The survival rate and complications were observed.Results All the patients were well tolerated.The AFP and tumor volume of the observation group at 12 months after the treatment were better than those of the control group (P<0.05).The rate of complete necrosis of tumor and total effective rate of the observation group were higher than those of the control group (P<0.05).The survival rate at 1 year,2 year and 3 year follow-up of the observation group were higher than those of the control group (P<0.05).Conclusion TACE combined with RFA can improve the rate of com-plete necrosis of tumor and total efficiency,control the tumor lesions and prolong the survival time of HCC patients,which has highly clinical application value.