目的 研究肝动脉化疗栓塞术(TACE)联合超声引导下射频消融术(RFA)治疗原发性肝癌的临床疗效.方法 选取第四军医大学附属西京医院肝胆外科2013年3月至2013年12月期间收治的进展期原发性肝癌124例,所有患者按照数字表法随机单盲分成对照组和观察组两个组,所有患者均先进行TACE治疗,对照组患者实行两次TACE,观察组先行TACE,再次行RFA.观察两组治疗疗效及生存率.结果 观察组肿瘤完全缓解率为23.6％、部分缓解率为25.7％、稳定率为29.8％,均明显高于对照组.观察组1年、2年及3年生存率分别为83.6％、62.1％、36.7％,对照组1年、2年及3年生存率分别为68.9％、45.2％、21.4％,两组间生存率比较存在统计学差异(P<0.05).结论 肝动脉化疗栓塞术联合超声引导下射频消融术是一种较好的综合治疗肝癌的方法.%Objective To investigate the clinical effect of transcatheter artery chemoembolization (TACE) combined with ultrasound-guided radiofrequency ablation (RFA) for treatment of primary hepatocellular carcinoma. Methods Patients with primary hepatocellular carcinoma were enrolled from Department of Hepatobiliary Surgery, Xijing Hospital of the Forth Military Medical University between Mar. 2013 and Dec. 2013, and were divided into two groups with a single-blinded, randomized method according to the digital table. All patients first received TACE treatment, followed by second TACE in the control group and RFA in the observation group. Treatment effect and survival rate between two groups were compared. Results In the observation group, the cure rate was 23.6％, the partial alleviation rate was 25.7％, and stability rate was 29.8％, which were all higher than those in the control group. The 1-, 2- and 3-year survival rates were 83.6％, 62.1％and 36.7％ respectively in observation group, and corresponding 68.9％, 45.2％ and 21.4％ in the control group. Survival rate in observation group was significantly higher than that in control group (P<0.05). Conclusion Our study suggests that the comprehensive treatment by transcatheter artery chemoembolization combined with ultrasound-guided radiofrequency ablation is effective for primary hepatocellular carcinoma.
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