TACE术联合RFA术对高危部位原发性肝癌的临床疗效分析

目的探讨经动脉栓塞术(TACE)联合射频消融术(RFA)对高危部位原发性肝癌的临床疗效。 方法回顾性分析自2013年4月至2018年4月收治的100例高危部位原发性肝癌患者资料，根据不同疗法分为两组，每组50例。TACE组患者采用TACE术进行治疗，联合组患者采用TACE术联合RFA术进行治疗。数据采用SPSS18.0进行分析，两组患者近期疗效、1年内生存率和术后并发症采用χ²检验，两组患者的甲胎蛋白(AFP)和体力状况评分(KPS)指标采用( ±s)表示，独立t检验，P<0.05差异有统计学意义。 结果联合组患者近期疗效高于TACE组(P<0.05)；联合组患者1年生存率为77.9%高于TACE组1年生存率54.6%(P<0.05)；术前，两组患者的AFP数值和KPS数值对比，差异无统计学意义(P>0.05)，术后，联合组患者的AFP数值低于TACE组(P<0.05)，但KPS数值高于TACE组(P<0.05)；联合组患者腹痛的不良反应率高于TACE组(P<0.05)，但其他各项不良反应均低于TACE组(P<0.05)。 结论TACE术联合RFA术对高危部位原发性肝癌的近期疗效比单纯TACE术要好，患者的生存期有所延长，联合术对不能实施手术治疗的原发性肝癌患者有着很好的应用价值，值得临床推广。

Clinical analysis of TACE combined with RFA in treating primary liver cancers of high-risk sites

Objective To investigate the clinical effect of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in the treatment of primary liver cancers of high-risk sites. Methods Clinical data of 100 patients with primary liver cancers of high-risk sites from April 2013 to April 2018 were analyzed retrospectively. According to different therapeutic treatments, 100 patients were divided into TACE group(50 cases) and Combined group(50 cases). Patients in TACE group received TACE, while patients in Combined group underwent both TACE and RFA. Statistical analysis were performed by using SPSS18.0 software. Count data such as 1-year survival rate, short-term outcome and postoperative complications were analyzed by using χ^2 test. Measurement data such as AFP and KPS were represented as (x±s) and were examined by using t test. A P value of < 0.05 was considered as statistical significant difference. Results Short-term curative effect in Combined group was significantly higher than that in TACE group(P<0.05), and the one-year survival rate of 77.9% in combined group was significantly higher than that 54.6% in TACE group(P<0.05). There was no significant difference between two groups in terms of AFP and KPS before operation(P>0.05). After operation, AFP in Combined group was much lower than that in TACE group(P<0.05), while KPS in Combined group was much higher than that in TACE group(P<0.05). The incidence of abdominal pain in Combined group was higher than that in TACE group(P<0.05), however other adverse reactions were lower than those in TACE group respectively(P<0.05). Conclusion TACE combined with RFA is better than TACE alone in the treatment of primary liver cancers of high-risk sites, with improved survival of the patients. The combined treatments have application value for patients with unresectable primary liver cancers, and it is worth of clinical promotion.