CAJ | 학술논문

目的：分析肝动脉化疗栓塞术（TACE）联合射频消融术（RFA）治疗无法手术的肝细胞癌（HCC）患者的疗效及预后因素。方法选择我院无法手术切除或不愿手术的肝细胞癌患者60例，随机分成TACE组（n=30）和TACE联合RFA治疗组（n=30），观察两组疗效、不良反应和生存时间。结果 TACE组的有效率为50.0％，联合治疗组为86.7％，组间差异有统计学意义（P<0.05）；中位生存时间分别为13个月和18个月（P<0.05）。联合治疗组1年和2年总生存率分别为73.3％（22/30）和20.0％（6/30），而TACE组为56.7％（17/30）和6.7％（2/30），组间差异均有统计学意义（P<0.05）。联合组谷丙转氨酶升高发生率53.3％（16/30）高于TACE组46.7％（14/30），但差异无统计学意义（P>0.05）。结论 TACE联合RFA治疗无法手术的肝细胞癌可提高患者生存率，延长患者的生存期；肿瘤多发、肿瘤毗邻肝脏脏面、肿瘤最大直径等3项指标是影响患者预后的危险因素。
목적：분석간동맥화료전새술（TACE）연합사빈소융술（RFA）치료무법수술적간세포암（HCC）환자적료효급예후인소。방법선택아원무법수술절제혹불원수술적간세포암환자60례，수궤분성TACE조（n=30）화TACE연합RFA치료조（n=30），관찰량조료효、불량반응화생존시간。결과 TACE조적유효솔위50.0％，연합치료조위86.7％，조간차이유통계학의의（P<0.05）；중위생존시간분별위13개월화18개월（P<0.05）。연합치료조1년화2년총생존솔분별위73.3％（22/30）화20.0％（6/30），이TACE조위56.7％（17/30）화6.7％（2/30），조간차이균유통계학의의（P<0.05）。연합조곡병전안매승고발생솔53.3％（16/30）고우TACE조46.7％（14/30），단차이무통계학의의（P>0.05）。결론 TACE연합RFA치료무법수술적간세포암가제고환자생존솔，연장환자적생존기；종류다발、종류비린간장장면、종류최대직경등3항지표시영향환자예후적위험인소。
Objective To analyze the efficacy of transcatheterarterial chemoembolization (TACE ) combined with radi-ofrequency ablation (RFA) for inoperable hepatocellular carcinoma (HCC) and the prognostic factors. Methods A toal of 60 cases of HCC patients who were unable or unwilling to carry out surgery were included in this study. Patients were divided into two groups, TACE group (n=30) and the TACE+RFA combined group (n=30). All patients were given TACE one or several times, while the patients in the TACE+RFA group were added with RFA 1~2 weeks after TACE treatment. Observe the curative effects, adverse reactions and the survival time. Results The total effective rate was 50.0%and 86.7%respec-tively in TACE group and TACE+RFA group, with statistical difference between the two groups (P<0.05) . The median survival time were 13 months and 18 months respectively in TACE group and TACE+RFA group (P<0.05). The 1-and 2-year survival rates were respectively 73.3%(22/30) and 20.0%(6/30) in the TACE+RFA group, but were respectively 56.7%(17/30) and 6.7%(2/30) in the TACE group (P<0.05). The incidence of rise of glutamic-pyruvic transaminase in the TACE+RFA group was 53.3%(16/30), higher than in the TACE group [46.7%(14/30)], but the difference had no statistical significance (P>0.05). Conclusion TACE combined with RFA could significantly increase the survival rate and prolong survival period of patients. The multiple lesions, the maximum diameter, and the location of tumors adjacent the liver vis-ceral surface are risk factors affecting prognosis.