刘芳　　季良　　姜海燕　陈男男　　陈志赫　宋微　　杜宁

[摘要] 目的 探讨双针微波消融结合经导管动脉化疗栓塞治疗巨大原发性肝癌的有效性。 方法 选取我院2017年1月至2018年8月收治的80例巨大原发性肝癌患者作为主要研究对象，将患者随机分为观察组与对照组，每组各40例，对照组患者给予肝癌经导管动脉化疗栓塞介入治疗，观察组患者给予双针微波消融结合经导管动脉化疗栓塞治疗。对比两組患者的近期治疗效果、远期生存率、肿瘤标志物和不良反应情况。 结果 两组患者治疗30 d后，对照组患者治疗总有效率为42.5%，观察组为75.0%，观察组明显高于对照组（P<0.05）;观察组患者在半年、1年和2年的生存率明显高于对照组（P<0.05），观察组患者的平均存活时间明显长于对照组（P<0.05）;通过对比两组患者治疗前与治疗30 d后肿瘤标志物水平发现，治疗前两组患者AFP水平比较，差异无统计学意义（P>0.05），治疗30 d后，观察组AFP水平明显低于对照组（P<0.05）;两组患者放射性肝病、胃肠道反应、肝功能受损、骨髓抑制、肝区疼痛不良反应发生率比较，差异无统计学意义（P>0.05）。 结论 针对巨大原发性肝癌患者应用双针微波消融结合经导管动脉化疗栓塞治疗与常规介入治疗相比，能够提升患者的近远期生存率，治疗效果更好，而且能够减少患者体内的肿瘤标志物，不增加不良反应，安全性好，值得临床应用推广。

[关键词] 双针微波消融;经导管动脉化疗栓塞;原发性肝癌;有效性;生存率

[中图分类号] R735.7          [文献标识码] A          [文章编号] 1673-9701（2021）13-0017-04

Effectiveness analysis of double needle microwave ablation combined with transcatheter arterial chemoembolization for hepatocel-lula carcinoma

LIU Fang1   JI Liang1   JIANG Haiyan1   CHEN Nannan1   CHEN Zhihe1   SONG Wei1   DU Ning2

1.Department of Infection， the Central Hospital of Jiamusi City in Heilongjiang Province， Jiamusi 154002， China; 2.School of Public Health， Jiamusi University， Jiamusi   154002， China

[Abstract] Objective To explore the effectiveness of double needle microwave ablation combined with transcatheter arterial chemoembolization in the treatment of hepatocel-lula carcinoma（HCC）. Methods A total of 80 patients with HCC admitted to our hospital from January 2017 to August 2018 were selected as the main research objects. The patients were randomly divided into the observation group and the control group， with 40 cases in each group. The patients in the control group were given transcatheter arterial chemoembolization， while the patients in the observation group were given double needle microwave ablation combined with transcatheter arterial chemoembolization. The short-term therapeutic effect， long-term survival rate， tumor markers and adverse reactions of the two groups of patients were compared. Results 30 days after treatment， the total therapeutic effective rate was 42.5% in the control group， which was significantly lower than 75.0% in the observation group（P<0.05）.The survival rates were significantly higher in the observation group half a year， one year and two years later than those in the control group（P<0.05）， and the mean survival time was significantly longer in the observation group than that in the control group（P<0.05）. By comparing the levels of tumor markers before treatment and 30 days after treatment， there was no significant difference in armor embryo protein （AFP） level between the two groups before treatment （P>0.05）， While 30 days after treatment， AFP level was significantly lower in the observation group  than that in the control group（P<0.05）. There were no significant differences between the observation group and the control group in the incidences of adverse reactions of radiation liver disease， gastrointestinal reactions， liver function damage， bone marrow suppression and liver pain （P>0.05）. Conclusion Compared with conventional interventional therapy， double needle microwave ablation combined with transcatheter arterial chemoembolization can improve the short-term and long-term survival rate of patients with HCC， with a better therapeutic effect， which can reduce tumor markers in patients， but does not increase adverse reactions， with higher safety. It is worthy of clinical application and promotion.

[Key words] Double needle microwave ablation; Transcatheter arterial chemoembolization; Hepatocel-lula carcinoma; Effectiveness; Survival rate

原发性肝癌是当前常见的一种恶性肿瘤，而且巨大型肝癌患者比较常见，其病情进展比较快，很多患者在已经确诊的时候就失去了根治术的机会，一般多应用介入治疗[1]。临床研究表明[2-3]，经导管动脉化疗栓塞介入术是巨大原发性肝癌患者的常用治疗方法，能够加速肿瘤细胞缺氧缺血坏死，并减少病灶血供。可以让化疗药物在患者的肿瘤栓塞处得到缓解释放，增强肿瘤细胞对于药物的敏感性，持续性将肿瘤细胞杀死，从而控制病情进展与肿瘤细胞增殖。……