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目的探讨奥曲肽在肝癌病人TACE(经导管动脉化疗栓塞)治疗中的价值。方法以介入治疗的中晚期肝癌病人作为研究对象,进行前瞻性临床随机对照研究。两组肝癌病人,实验组50例,以超液化碘油(10~20 m l)和奥曲肽0.5 mg进行栓塞化疗;对照组50例,以超液化碘油(10~20 m l)和5-氟尿嘧啶(500~1000 mg)、丝裂霉素(10~20 mg)、卡铂(200~400 mg)进行栓塞化疗,检测治疗前后各相关生化指标的变化,测量肿瘤大小,随访生存期。结果实验组1年累积生存率87.56%,对照组为72.35%,两组间差别有统计学意义。试验组与对照组在治疗前后肿瘤大小相比有统计学意义。二组病人介入治疗前后透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)、板层素(LN)、甲胎蛋白的差异均有统计学意义,奥曲肽对患者的肝肾功能、造血系统及胃肠道系统无明显影响。结论以奥曲肽作为灌注药物,对肝癌病人进行化疗栓塞与常规化疗栓塞相比,疗效优于常规化疗栓塞,而毒副作用明显减轻。
Objective To investigate the value of octreotide in the treatment of hepatocellular carcinoma (TACE) by transcatheter arterial chemoembolization. Methods Interventional treatment of advanced liver cancer patients as the research object, prospective clinical randomized controlled study. Two groups of patients with liver cancer, experimental group of 50 patients with ultra-liquefied lipiodol (10 ~ 20 ml) and octreotide 0.5 mg for embolization chemotherapy; control group of 50 patients with hyperlipemia lipiodol (10 ~ 20 ml) and 5-fluorouracil 500 ~ 1000 mg), mitomycin (10 ~ 20 mg), and carboplatin (200 ~ 400 mg). The changes of biochemical indexes before and after treatment were measured. The tumor size and follow-up survival were measured. Results The 1-year cumulative survival rate was 87.56% in the experimental group and 72.35% in the control group, with significant difference between the two groups. Test group and control group in the size of tumor before and after treatment was statistically significant. The difference of HA, PCⅢ, C-Ⅳ, LN and AFP between the two groups before and after interventional therapy was statistically significant. Patients with liver and kidney function, hematopoietic system and gastrointestinal system had no significant effect. Conclusion With octreotide as a perfusion drug, chemoembolization in patients with hepatocellular carcinoma is superior to conventional chemoembolization compared with conventional chemoembolization, and toxicity and side effects are significantly reduced.