李明非　曾　勇　关　华　甘险峰.四川省人民医院肝胆外科，四川成都　6007；.四川大学华西附属医院肝胆外科，四川成都　60000；.四川省人民医院体检中心，四川成都　6007

原发性肝癌手术治疗的疗效及预后情况的影响因素探讨

李明非1曾勇2关华3甘险峰1
1.四川省人民医院肝胆外科，四川成都610072；2.四川大学华西附属医院肝胆外科，四川成都610000；3.四川省人民医院体检中心，四川成都610072

目的 对我院原发性肝癌患者进行回顾性分析，探讨手术治疗原发性肝癌的疗效以及相关的影响因素。方法 选择我院2008年1月～2010年1月原发性肝癌手术患者作为研究对象，回顾性分析患者的治疗情况和术后预后有关的影响因素。结果①观察组总控制率 （97%）明显高于对照组 （68%），差异具有统计学意义 （P＜0.05）。②在轻度不良反应方面，观察组恶心呕吐、腹痛腹泻发生率分别为7.7%、4.6%，和对照组比较差异无统计学意义（P＞0.05）。在重度不良反应方面，观察组白细胞降低、谷丙转氨酶升高、放射性肝病发生率分别为3.1%、4.6%、3.1%。③肿瘤分布位置、肿瘤大小、肿瘤数目、术前AFP、术前术后AFP变化、Child分级、血管侵犯、辅助治疗、肝硬化和患者的生存率具有显著相关性。④影响手术预后情况的独立因素包括肿瘤大小、肿瘤数目、术前术后AFP变化、Child分级、血管侵犯、肝硬化。结论 外科切除手术是治疗原发性肝癌的有效方法，但是其预后情况受到多方面因素的影响，外科切除手术和TACE术联合治疗有助于提高治疗效果。

手术治疗；TACE联合治疗；Child分级；原发性肝癌；影响因素

［Abstract］Objective To investigate the therapeutic effect and related factors of primary liver cancer in our hospital. Methods The patients with primary liver cancer surgery in our hospital from January 2008 to January 2010 were selected as the study subjects.The influencing factors of the treatment and postoperative prognosis of patients with primary liver cancer were analyzed retrospectively.Results①The total control rate of the observation group（97%）was significantly higher than that of the control group（68%），the difference between the two groups was statistically significant（P＜0.05）.②In mild adverse reactions，the incidence of nausea and vomiting and diarrhea in the observation group were 7.7%，4.6%，and compared with the control group，the difference between the two groups was not statistically significant （P＞0.05）.In the severe adverse reactions，the incidence of white blood cells decrease，alanine aminotransferase increase，radiation liver disease in the observation group were 3.1%，4.6%，3.1%.③Tumor location，tumor size，number of tumors，preoperative AFP，postoperative AFP changes，Child classification，vascular invasion，adjuvant therapy，liver cirrhosis had significant correlation with the survival rate of patients.④The independent factors influencing the prognosis of surgery included tumor size，tumor number，preoperative AFP changes，Child grading，vascular invasion，and liver cirrhosis.Conclusion Surgical resection is the efficient treatment of primary hepatocellular carcinoma，but the prognosis is influenced by many factors，surgical resection surgery and TACE treatment is beneficial to improve the efficiency of treatment.

［Key words］Surgical treatment；TACE combined with conventional treatment；Child classification；Primary liver cancer；Affecting factors

原发性肝癌属于一种临床常见的恶性肿瘤，在全球范围内具有较高的发病率和死亡率，其中我国原发性肝癌发病率正在不断增加，已经成为我国高发的重大疾病之一［1，2］。……