[1]石钦,周晨,刘家成,等.膈下肝癌经肝动脉化疗栓塞联合射频消融的临床疗效分析 [J].介入放射学杂志,2020,29(02):154-158.
　SHI Qin,ZHOU Chen,LIU Jiacheng,et al.Transcatheter arterial chemoembolization combined with radiofrequency ablation for subphrenic hepatocellular carcinoma: analysis of clinical effect[J].journal interventional radiology,2020,29(02):154-158.
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膈下肝癌经肝动脉化疗栓塞联合射频消融的临床疗效分析

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年02
页码:
154-158
栏目:
肿瘤介入
出版日期:
2020-03-14

文章信息/Info

Title:
Transcatheter arterial chemoembolization combined with radiofrequency ablation for subphrenic hepatocellular carcinoma: analysis of clinical effect
作者:
石钦; 周晨; 刘家成; 钱坤; 刘一鸣; 宋松林; 郑传胜; 熊斌
Author(s):
SHI Qin;  ZHOU Chen;  LIU Jiacheng;  QIAN Kun;  LIU Yiming;  SONG Songlin;  ZHENG Chuansheng;  XIONG Bin.
Department of Radiology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Key Laboratory of Molecular Image of Hubei Province, Wuhan, Hubei Province 430022, China
关键词:
【关键词】　膈下肝癌; 经肝动脉化疗栓塞; 射频消融; 镇痛; 疗效
文献标志码:
A
摘要:
【摘要】　目的?评估经肝动脉化疗栓塞（TACE）联合射频消融（RFA）治疗膈下肝癌的安全性与有效性。方法?选取2014年3月至2018年11月行TACE联合RFA治疗的膈下肝癌患者55例。随访期间评估所有患者术后肿瘤反应及生存率，比较治疗前后血生化、AFP及肝功能指标变化，并总结患者术后并发症的发生情况。结果?在55例肝癌患者共61处膈下病灶中，30处病灶（49.2%）完全缓解（CR），24处病灶（39.3%）部分缓解（PR），7处病灶（11.5%）疾病稳定（SD），无病灶疾病进展（PD）。客观反应率（ORR）为88.5%，疾病控制率（DCR）为100%，所有患者均获益。治疗前后肝功能及血生化指标无明显差异（P＞0.05），但术后AFP值明显下降，差异具有统计学意义（t?=3.277，P＜0.05）。所有患者在围手术期未出现严重并发症。结论?TACE联合RFA对膈下肝癌疗效显著。在RFA治疗过程中出现的疼痛，通过术前静脉滴注氟比洛芬酯或地佐辛并联合利多卡因局麻，术中加入适量利多卡因与0.9%NaCl溶液1:1稀释液经进水孔对肿瘤病灶进行灌注麻醉，必要时给予吗啡肌注，可显著缓解患者疼痛。

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备注/Memo

备注/Memo:
（收稿日期：2019-04-11）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2020-03-13