大肝癌切除术后化疗的临床分析_临床医学论文.docVIP

大肝癌切除术后化疗的临床分析_临床医学论文 大肝癌切除术后化疗的临床分析_临床医学论文 【摘要】 目的 探讨肝癌术后化疗的作用，提高手术治疗效果。方法 分析25例原发性肝癌患者术后辅助化疗的临床资料，化疗采用FAP方案:四氢叶酸钙（CF）200 mg/m2，5-氟尿嘧啶（5-FU）500 mg/m2，静脉滴注，第1～5天;阿霉素（ADM）40 mg/m2，顺铂（CDDP）30 mg/m2，静脉滴注第1天，在护理上，应加强静脉、口腔及心理护理，预防感染，以提高患者的生活质量。结果 25例患者至今存活23例，最长36个月，死亡2例，生存期均超过了1年，其中1例死于术后11个月，1例死于20个月，死亡原因均为肿瘤转移。化疗毒副反应轻。结论 肝癌患者术后辅助化疗是可行的、副作用小；对患者做好心理护理，营养支持及早预防，及时处理化疗药的毒副作用，可有效减轻患者痛苦，提高生存质量，延长患者生存期。 【关键词】 肝切除;肝肿瘤;辅助化疗 ［Abstract］ Objective To investigate the feasibility，reliability and therapeutic effectiveness of adjuvant chemotherapy for advanced hepatocellular carcinoma（HCC）after liver resection.Methods The clinical data of adjuvant chemotherapy after 25 liver resection in 25 patients were studied retrospectively.FAP chemotherapy regiment was adopted，including calcium folinate（CF），200 mg/m2 and 5-Flurorouracil 500 mg/m2 iv on D1 to D5，and doxorubicin 40 mg/m2，cisplatin 30 mg/m2 iv on D1，with 28 days as a cycle.Any of nursing care protocol including strengthening the mental care of patients，improving the nutrition support，preventing and treating the infection were taken.Results 23/25 patients are surviving，with a longest survival of 36 months.Two patients died after operation，one at 11 months，another at 20 months after liver resection，all died of metastasis.The side-effects of adjuvant chemotherapy were moderate.Conclusion Chemotherapy which is able to prolong the life-span of patients with advanced HCC after liver resection is feasible and effective，the side-effects were mild.In addition，the reasonable nursing care protocol is helpful to prolong the life-span of patients and to enhance the living quality of these patients with advanced HCC after liver resection. ［Key words］ liver resection；HCC;hepatocellular carcinoma;adjuvant chemotherapy 肝细胞性肝癌（hepatocellular carcinoma，HCC）是最常见的恶性肿瘤之一，对于平均自然生存期为2～3个月的肝癌患者，肝切除治疗后1年生存率达85.7%，已是很大的进步［1］。随着化疗药物的发展和正确使用，肝切除治疗肝癌患者的疗效得到了进一步提高［2］。2005年8月至2007年12月北京佑安医院外科行肝癌切除术治疗肝癌共25例，其中复发性肝癌2例，均在术后进行了全身化疗，近期疗效满意，说明肝癌后化疗对降低肝癌术后复发有重要意义，而