TACE联合RFA、PVC不同顺序治疗不能切除肝癌的临床疗效研究外科学专业论文.docxVIP

PAGE PAGE 2 （P＞0.05）；各组瘤灶数量无明显差异（P＞0.05）；综合组的伴门静脉 癌栓数量减少，对照组稍增加，综1与对照组相比P＜0.05，综1与综2、综 2与对照组相比，差异无统计学意义（P＞0.05）；各组的肝功能均下降（P ＞0.05）；综合组治疗后严重并发症发生率稍高于对照组（P＞0.05）； 综合1组的瘤体内血流减少率、肿瘤消融率明显高于其他两组，但与综2 相比差异无统计学意义（P＞0.05）；综1组肿瘤转移率明显低于其他两组， 3但与综2相比差异无统计学意义（P＞0.05）；各组CD + 3 4+ 4 T、CD + T无明显 差异（P＞0.05）；与另外两组相比，综合1组CD8 T显著降低（P＜0.05）， + + CD4 /CD8 T显著升高（P＜0.05），综合2组与对照组相比无明显差异（P ＞0.05）；与对照组相比，综合1组NK细胞显著升高（P＜0.05），综合2 组明显升高，但差异无统计学意义（P＞0.05）。 结 论 ： 1、RFA、TACE 和 PVC 综合治疗原发性肝癌可取得较 好的临床疗效，且能显著提高患者的细胞免疫功能；2、TACE 联合 RFA、 PVC 治疗不能切除肝癌的临床疗效优于 RFA、PVC 联合 TACE。 关键词 ：肝癌；综合治疗；TACE；RFA；T 淋巴细胞亚群 Compared the clinical efficacy of TACE combined RFA、 PVC in a different order treatment of unresectable HCC Abstract Objective: To comparative analysis the clinical efficacy of RFA, PVC joint TACE and TACE combined RFA,PVC treatment of unresectable liver cancer in a different order (mainly hepatocellular carcinoma, HCC)and effects on immune function . Methods: Select primary liver cancer 60 cases which unable or unwilling to seek treatment for liver cancer surgery from the First Affiliated Hospital of Guangxi Traditional Chinese Medicine in October 2009 to October 2010. 60 patients were divided into TACE combined RFA、PVC treatment group (20 cases, consolidated group 1), RFA、PVC combined TACE treatment group (20 cases, consolidated group 2), RFA alone treatment group 20 patients (control group) randomly. Among groups were compared in the different of gender, age, liver function classification, AFP value, the number of tumors, tumor size, with portal vein tumor thrombus, tumor blood supply, T cell subsets and NK cells before treatment and after treatment；Each group was compared before and after treatment in liver function classification、AFP value、the number of tumors、tumor size、with portal vein tumor thrombus、tumor blood supply、T cell subsets and NK cells；Compared the incidence of serious complications , the rate of tumor ablation 3 months after treatmentand the rate of tumor met