不同肝功能分级大肝癌TACE碘油剂量与疗效相关性与研究.pdfVIP

不同肝功能分级的大肝癌TACE 碘油剂量与疗效 的相关性研究 钟涛 杨思福 于红光 王勇 濮阳市油田总医院放射科,河南濮阳，457001 摘要 目的 探讨肝功能Child A 级与Child B 级TACE 时,碘油剂量对大肝癌的疗效影响。方法 回顾 性分析 106 例大肝癌患者，按照碘油用量分为A、B 两组，术后四周CT 扫描观察碘油聚积形式、检测AFP 水平和进行肝功能分级，并对1、2、3 年生存率进行分析。结果 A 组术后碘油聚积为第一类型、第二类型 的数量和血清AFP 下降强度均明显高于B 组，但术后肝功能分级较B 组差，比较1、2、3 年生存率，Child A 级的两组有显著差异，A 组高于B 组。结论 肝功能分级为Child B 级的大肝癌患者，为避免肝功能进一 步损害，应适当减少栓塞剂的用量；而肝功能级别为Child A 的肝癌患者，可以适当的加大碘油栓塞的剂 量，能获得较满意的近期和远期疗效。 关键词 肝癌；肝动脉化疗栓塞（TACE）；肝功能；Child-Pugh 分级；碘油 Study of lipiodol dose in evaluating the effect of TACE for large hepatocellular carcinoma of different liver function Zhong Tao, Yang Sifu, Yu Hongguang, Wang Yong Department of Radiology, Zhongyuan Oil-field General Hospital, Puyang, Henan. Abstract Objective To investigate the influence of lipiodol dose in evaluating the effect of TACE for large hepatocellular carcinoma of different liver function, including Child A and Child B. Methods Review analysis 106 patients with large hepatocellular carcinoma were divided into two groups according lipiodol dose. Four weeks after TACE, the liver function evaluated with Child-Pugh scores, the lipiodol accumulation detected by CT, and AFP test were performed. Then the 1-,2-,3-year cumulative survival rates of the patients were analyzed Results More type Ⅰand type Ⅱlipiodol accumulations in CT scan and serum AFP reduce degrees after 4 weeks of TACE were seen in the group A patients than those in the group B patients. But the Child-Pugh score was increased than those in the group B patients. The 1-,2-,3-year survival rates of group A patients with Child grade A were respectively better than those of group B. Conclusion In treatment of a Child grade B patient by TACE, low-dose lipiodol should be used to avoid the liver function harmful. For the patie