肝细胞性肝癌手术治疗的疗效及影响因素观察.docVIP

rawm梧向因和陳 2018-03-27 12:00:30中国现代医生2018年3期 王壯叶冠雄许晓雅徐胜前吴成军秦勇潘德标 ［摘要］目的研究并探讨手术治疗肝细胞性肝癌的临床疗效，并分析影响肝细胞性肝癌疗效的危 险因索，为完善肝细胞性肝癌手术治疗提供参考依据。方法 入组对彖选择2013年1月?2017年9 月期间在我院接受手术治疗且完成3年术后随访的200例肝细胞性肝癌患者，对其手术疗效进行评 估。根据200例肝细胞性肝癌患者随访3年存活情况，将其分为存活组、死亡组，比较两组临床资 料，对影响肝细胞性肝癌手术预后的危险因索进行单因索分析、多因素Logistic线性回归分析。結 果200例肝细胞性肝癌患者经手术治疗后，其短期客观缓解率为63.50%,术后均未发牛并发症，其 复发率为24.50%, 3年存活率、死亡率分别为79.00%、21.00%。单因素分析屮，两组在肿瘤直径、 肿瘤分化程度、肿瘤间质细胞比、血管侵犯、术前甲胎蛋白水平等方面比较差异均有统计学意义 (P0.05),而经多因素Logistic线性冋归分析后发现，肿瘤直径n5 cm、肿瘤分化程度低、肿瘤间 质细胞比50%、血管侵犯、术前甲胎蛋口水平》400 ng/mL是影响肝细胞性肝癌患者手术预后的危险 因素。结论肝细胞性肝癌患者手术治疗后的预后受到肿瘤直径、肿瘤分化程度、肿瘤间质细胞比、 血管侵犯、术前甲胎蛋白水平的影响，临床上需针对相关危险因素合理调整手术方案。 ［关键词］肝细胞性肝癌；手术；影响因素；血管侵犯 ［中图分类号］R735.7 ［文献标识码］B ［文章编1673-9701 (2018) 03-0044-03 Observatio n on the efficacy of surgical treatment of hepatocellular carci noma and its in flue ncing factors WANG Shi YE Guanxiong XU Xiaoya XU Shengqian WU Chengjun QIN Yong PAN Debiao No.1 Ward of General Surgery, Lishui People兮 Hospital in Zhejiang Province, Lishui 323000, China [Abstract] Objective To study and discuss the clinical efficacy of surgical treatment of hepatocellular carci noma (HCC) and to analyze the risk factors affecting the therapeutic effect of hepatocellular carcinoma (HCC), so as to provide references for improving the surgical treatment of hepatocellular carci noma. Methods The en rolled subjects were selected from 200 patie nts with hepatocellular carci noma who un derwe nt surgery in our hospital from January 2013 to September 2017 and were followed up for 3 years? The efficacy of surgery was evaluated. According to the survival conditions of these 200 patie nts with hepatocellular carci noma who were followed up for 3 years, they were divided into survival group and death group, and the clinical data were compared betwee n the two groups. The risk factors affecti ng the surgical prog nosis of hepatocellular carci noma were an alyzed by univariate analysis and multivariate Logistic lin ear regression analysis. Results After surgical treatment for 2