肝动脉化疗栓塞术治疗肝恶性肿瘤对肝功能的影响.pdfVIP

当代医学 2011年5月第l7卷第14期总第241期 ContemporaryMedicine，May．2011，Vo1．17No．14IssueNo．241 doi：10．3969／J．i ．1009-4393．2011．5．014 肝动脉化疗栓塞术治疗肝恶性肿瘤对肝功能的影响 许飞 王四明 史仲华 孙伟 李忱瑞 [摘要] 目的 探讨肝动脉化疗栓塞术 (TACE)治疗肝恶性肿瘤对肝功能的影响。方法 回顾性分析42例肝恶性肿瘤 (原发性肝癌36例 ，肝转移 瘤6例)第一次TACE术前、术后 I天、1周、2周、4 6周及多次TACE后的肝功能。结果 术后1天、1周的ALT、TBIL、DBIL及术后 1天的AST，均较术前明显 增高(JD0001)；术后2周、4--6周的ALT、AST、TNL、DI31L与术前相比，差异无显著性(p0o5)；多次~-AOE后Child—Pugh分级虽有改变但无显著差异 (P 005)。结论 TACE术治疗肝恶性肿瘤对肝功能有一定损伤，但术后2—4周可恢复至术前水平，术前、术中及术后应关注肝功能的保护。 [关键词】 肝肿瘤；肝动脉栓塞化疗；肝功能 TheHepaticFunctionDamageafterTransarterialChemoembolizationsforTreatingHepaticMalignantTumor XUFei，WANG Si-ming，SHIZhong—hua，SUNWei，LIChen—rui DepartmentofRadiology，CancerHospital，ChineseACademyofMedical Sciences，Beijing100021；People’sHospitalofYuXi，Yunnan，653100 A【bstract]ObjectiveToinvestigatethehepaticfunctiondamageafterrtansartefialchemoembolizations(TACE)fortreatinghepaticmalignant tumor．MethodsForty—twopatientswithhepaticmaling anttumorunderwentrepeatedTACE．Thehepaticfunctionchangesofpre—operation，post- operativeoneday,oneweek，wtoweeks，fourweeksafterhtefirsttreatmentandthehepaticfunctionafterrepeatedrteatmentwereretrospectively reviewed．ResultThemedianvalueofAL AS TBILandDBIL ofpost—operativeonedayweresing ificantlyhigherthanthatofpre—operation (P0．001)．ThemedianvalueofA TBILandDBILofpost—operativeoneweekweresingificantlyhigherthanthatofpre—operation(P0．OO1)．There werenosingificantdifferencebewteenthatofpost—operativewtoweeks，fourweeksandthatofpre—operation(P0．05)．Therewerenosignificant differenceinChild—PughgradingafterrepeatedTACErPO．05)．ConclusionsThehepaticfunctiondamageafterTACEcanrecovertohtevalueof post—operativein2-4weeks．Thehepaticfimctionshouldbegetprotectionfrompre—operationtopost—operation． K【eyWords】Hepaticutmor；Transarterialchemoembolization；Hepaticfunction 原发性肝癌是严重危及人类健康的恶性肿瘤之一，每年全