[1]徐文海,许 伟,祖茂衡,等.经导管动脉化疗栓塞治疗经颈静脉肝内门体分流术后肝细胞癌临床应用评价 [J].介入放射学杂志,2021,30(10):1052-1056.
　XU Wenhai,XU Wei,ZU Maoheng,et al.Clinical application of transcatheter arterial chemoembolization in treating patients with hepatocellular carcinoma after receiving transjugular intrahepatic portosystemic shunt[J].journal interventional radiology,2021,30(10):1052-1056.
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经导管动脉化疗栓塞治疗经颈静脉肝内门体分流术后肝细胞癌临床应用评价 
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年10
页码:
1052-1056
栏目:
临床研究
出版日期:
2021-10-25

文章信息/Info

Title:
Clinical application of transcatheter arterial chemoembolization in treating patients with hepatocellular carcinoma after receiving transjugular intrahepatic portosystemic shunt
作者:
徐文海;  许 伟;  祖茂衡;  徐 浩;  王 勇
Author(s):
XU Wenhai;  XU Wei;  ZU Maoheng;  XU Hao;  WANG Yong.
Department of Interventional Radiology， Affiliated Hospital of Xuzhou Medical University， Xuzhou， Jiangsu Province 221006， China
关键词:
【关键词】 经颈静脉肝内门体分流术;  经导管动脉化疗栓塞术;  肝细胞癌;  疗效
文献标志码:
A
摘要:
【摘要】 目的 探讨经导管动脉化疗栓塞术（TACE）治疗经颈静脉肝内门体分流术（TIPS）后肝细胞癌（HCC）的安全性和近期效果。方法 回顾性分析2014年8月至2019年12月在徐州医科大学附属医院接受TACE治疗的41例HCC患者临床资料。其中20例TACE术前存在TIPS治疗患者为观察组，同期21例TACE术前无TIPS治疗患者为对照组。比较两组间TACE治疗前后肝功能、血常规，术后不良反应、并发症发生及严重不良事件发生情况，根据改良实体瘤疗效评价标准（mRECIST）结合影像学检查评价术后近期疗效。结果 两组患者基线特征差异无统计学意义（P＞0.05）。两组TACE术均获成功，无严重并发症和手术相关死亡。除血清白蛋白（ALB）外，两组间术前、术后1周总胆红素（TBil）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、白细胞（WBC）、红细胞（RBC）、血小板（PLT）差异均无统计学意义（P＞0.05）。观察组与对照组相比，患者术后1周腹痛、发热、恶心、呕吐等不良反应发生率和术后6个月肿瘤反应率差异均无统计学意义（P＞0.05）。结论 即使HCC患者之前接受过TIPS治疗，行TACE术仍安全有效。

参考文献/References:


［1］ Zhou M， Wang H， Zeng X， et al. Mortality， morbidity， and risk factors in China and its provinces，1990-2017： a systematic analysis for the Global Burden of Disease Study 2017［J］. Lancet， 2019， 394：1145-1158.
［2］ Heimbach JK， Kulik LM， Finn RS， et al. AASLD guidelines for the treatment of hepatocellular carcinoma［J］. Hepatology， 2018，67：358-380.
［3］ Sapisochin G， Barry A， Doherty M， et al. Stereotactic body radiotherapy vs. TACE or RFA as a bridge to transplant in patients with hepatocellular carcinoma. An intention-to-treat analysis［J］. J Hepatol， 2017， 67：92-99.
［4］ Garcia-Pagan JC， Caca K， Bureau C， et al. Early use of TIPS in patients with cirrhosis and variceal bleeding［J］. N Engl J Med，2010， 362：2370-2379.
［5］ 吴晶晶，李迎春，孙 勇，等. TIPS术后肝脏灌注指标的变化及临床意义［J］. 中国临床医学影像杂志， 2015， 26：217-219.
［6］ Kuo YC， Kohi MP， Naeger DM， et al. Efficacy of TACE in TIPS patients： comparison of treatment response to chemoem-bolization for hepatocellular carcinoma in patients with and without a transjugular intrahepatic portosystemic shunt［J］. Cardiovasc Intervent Radiol， 2013， 36：1336-1343.
［7］ Lencioni R， Llovet JM. Modified RECIST（mRECIST） assessment for hepatocellular carcinoma［J］. Semin Liver Dis， 2010， 30：52- 60.
［8］ Li Y， Zhang Z， Shi J， et al. Risk factors for naturally- occurring early- onset hepatocellular carcinoma in patients with HBV-associated liver cirrhosis in China［J］. Int J Clin Exp Med， 2015， 8：1205-1212.
［9］ Galati G， De Vincentis A， Ripetti V， et al. Haemorrhoidal disease in severe portal hypertension： a combined approach with transjugular intrahepatic portosystemic shunt（TIPS） and transanal haemorrhoidal dearterialization（THD）［J］. Arch Med Sci， 2014，10：195-196.
［10］ Qiu B， Zhao MF， Yue ZD， et al. Combined transjugular intrahepatic portosystemic shunt and other interventions for hepatocellular carcinoma with portal hypertension［J］. World J Gastroenterol， 2015， 21：12439-12447.
［11］ 侯昌龙，许 军，秦汉林，等. 经颈静脉肝内门体分流术联合介入治疗肝癌伴门静脉高压症的疗效［J］. 中华消化杂志， 2020， 40：474- 479.
［12］ 周思佳，罗小平，何明菊，等. 肝癌合并肝硬化门脉高压症行TACE联合TIPS治疗的安全性与疗效［J］. 重庆医学， 2017，46 ：4958-4962.
［13］ Stankovic Z， Rossle M， Euringer W， et al. Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI［J］. Eur Radiol， 2015， 25：2634-2640.
［14］ Ruohoniemi DM， Taslakian B， Aaltonen EA， et al. Comparative analysis of safety and efficacy of transarterial chemoembolization for the treatment of hepatocellular carcinoma in patients with and without pre- existing transjugular intrahepatic portosystemic shunts［J］. J Vasc Interv Radiol， 2020， 31：409- 415.
［15］ Kohi MP， Fidelman N， Naeger DM， et al. Hepatotoxicity after transarterial chemoembolization and transjugular intrahepatic portosystemic shunt： do two rights make a wrong?［J］. J Vasc Interv Radiol， 2013， 24：68-73.
［16］ 翟 越，赵 卫，潘文秋，等. TACE联合载药微球治疗肝癌的研究进展［J］. 介入放射学杂志， 2019， 28：1211-1214.
［17］ Zhong C， Guo RP， Li JQ， et al. A randomized controlled trial of hepatectomy with adjuvant transcatheter arterial chemoembolization versus hepatectomy alone for stage ⅢA hepatocellular carcinoma［J］. J Cancer Res Clin Oncol， 2009， 135：1437-1445.

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备注/Memo

备注/Memo:
（收稿日期：2020-09-08）
（本文编辑：边 佶）
更新日期/Last Update: 2021-10-15