肝动脉造影化疗栓塞术联合替吉奥胶囊治疗原发性肝癌患者的临床疗效

丁可 韩菲菲 徐庆

【摘要】 目的：探究肝动脉造影化疗栓塞术（TACE）联合替吉奥胶囊治疗原发性肝癌的临床效果。方法：选取2016年12月-2018年12月本院收治的原发性肝癌患者40例。按照随机数字分配法将其分为试验组与对照组，各20例。对照组采取TACE术，试验组采取TACE术联合替吉奥胶囊方案。比较两组临床疗效、肝肾功能（ALT、TBIL、AST、β2-MG、BUN及Scr）水平以及CT灌注值。结果：试验组临床总有效率为85.00%，高于对照组的55.00%（P<0.05）;治疗后，试验组血流量（BF）、血容量（BV）、对比剂的平均通过时间（MTT）、表面通透性（Ps）、肝动脉分数（HAP）、肝动脉灌注量、总肝灌注量及肝动脉灌注指数均低于对照组，门静脉灌流量高于对照组，差异均有统计学意义（P<0.05）;治疗后，试验组ALT、TBIL、AST均低于对照组（P<0.05），两组治疗前后β2-MG、BUN及Scr比较，差异均无统计学意义（P>0.05）。结论：经TACE联合替吉奥胶囊治疗的原发性肝癌患者治疗效果显著，且安全性较好。

【关键词】 肝动脉造影化疗栓塞术; 替吉奥胶囊; 原发性肝癌

【Abstract】 Objective：To investigate the clinical efficacy of hepatic arteriography chemoembolization and Tegio Capsules in treatment of primary hepatocellular carcinoma.Method：A total of 40 patients with primary hepatocellular carcinoma admitted to our hospital from December 2016 to December 2018 were selected.According to the random number distribution method，they were divided into experimental group and control group，20 cases in each group.The control group was treated with TACE，and experimental group was treated with TACE combined with Tegio Capsules.The clinical efficacy，liver and kidney function（ALT，TBIL，AST，β2-MG，BUN and Scr）and CT perfusion values between two groups were compared.Result：The total clinical effective rate of experimental group was 85.00%，which was higher than 55.00% of control group（P<0.05）.After treatment，the blood flow（BF），blood volume（BV），mean transit time（MTT），surface permeability（Ps），hepatic artery fraction（HAP），hepatic artery perfusion volume，total hepatic perfusion volume and hepatic artery perfusion index of experimental group were lower than those of control group，and the portal vein perfusion volume was higher than that of control group，the differences were statistically significant（P<0.05）.After treatment，the levels of ALT，TBIL and AST in experimental group were lower than those of control group（P<0.05），the levels of β2-MG，BUN and Scr before and after treatment were compared between two groups，the differences were not statistically significant（P>0.05）.Conclusion：The treatment of primary hepatocellular carcinoma patients by TACE combined with Tegio Capsule is effective and safe.

【Key words】 Hepatic arteriography chemoembolization; Tegio Capsules; Primary hepatocellular carcinoma

First-authors address：Wuyi Hospital of Traditional Chinese Medicine，Jiangmen 529000，China

doi：10.3969/j.issn.1674-4985.2019.17.003

原發性肝癌是以肝区疼痛、肝肿大及乏力、食欲减退、腹胀、呕吐等一系列症状为主要表现的恶性肿瘤[1]。统计学研究显示，原发性肝癌全球发病率及死亡率逐年增高，我国肝癌发病率约为30.3/10万，年死亡人数约为14万，占全球死亡人数的42.62%[2]。原发性肝癌发病较为隐匿，且进展迅速，诸多患者于就诊时已至中晚期，失去手术治疗的机会且预后较差。当前针对此类患者常采取肝动脉造影化疗栓塞术（TACE）[3]。然而临床对TACE存在诸多争议，除TACE外，联合射频消融、冷冻、索拉非尼及全身化疗等均为本病的常见治疗方案。当今新药物索拉非尼以及贝伐单抗因其价格昂贵及其存在的毒性反应暂时无法被大众接受[4]。替吉奥胶囊是能够抑制癌症细胞增殖的氟尿嘧啶衍生口服药物，曾有研究表明，替吉奥能用于控制癌症晚期肝转移，从而提高生活质量[5]。本研究选取40例原发性肝癌患者，对TACE联合替吉奥胶囊治疗原发性肝癌患者的临床疗效进行研究。……