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乙型肝炎继发肝癌患者TACE术围术期使用恩替卡韦的临床观察
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| 篇名： | 乙型肝炎继发肝癌患者TACE术围术期使用恩替卡韦的临床观察 |
| TITLE： | |
| 摘要： | 目的： 观察乙型肝炎（以下简称“乙肝”）继发肝癌患者肝动脉化疗栓塞（TACE）术围术期使用恩替卡韦辅助治疗的临床疗效及安全性。方法：选取我院2012年6月－2013年6月拟行TACE术的乙肝继发肝癌患者130例，按照随机数字表法分为对照组和观察组，各65例。对照组患者给予TACE术治疗，化疗药物方案为氟尿嘧啶注射液20 mL +盐酸表柔比星注射液10 mL加入0.9％氯化钠注射液500 mL，ivgtt；观察组患者在TACE术前1周开始给予马来酸恩替卡韦片0.5 mg，po，qd，连续治疗12个月。比较两组患者临床疗效、甲胎蛋白（AFP）水平、乙肝病毒（HBV）DNA定量、丙氨酸转氨酶（ALT）水平、日常生活质量评分和生存率，并记录不良反应发生情况。结果：治疗前，两组患者AFP水平、HBV-DNA定量、ALT水平和日常生活质量评分比较，差异均无统计学意义（P＞0.05）。治疗后，观察组患者治疗总有效率显著高于对照组（41.54％ vs. 20.00％），AFP水平、HBV-DNA定量和ALT水平明显低于对照组，日常生活质量评分明显高于对照组，差异均有统计学意义（P＜0.05）。观察组患者随访1、2、3年的生存率均明显高于对照组（分别为75.38％ vs. 52.31％、53.85％ vs. 29.23％、32.31％ vs. 15.38％），差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：乙肝继发肝癌患者TACE术围术期使用恩替卡韦辅助治疗可有效控制患者疾病进展，保护肝功能，提高日常生活质量，并有助于提高总生存率，且安全性好。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of entecavir in adjunctive treatment of hepatitis B secondary liver cancer during perioperative period of transcatheter arterial chemoembolization （TACE）. METHODS： 130 patients from our hospital during Jun. 2012 to Jun. 2013 with hepatitis B secondary liver cancer undergoing TACE were selected and divided into control group and observation group according to random number table， with 65 cases in each group. Control group received TACE. Fluorouracil injection 20 mL+Epirubicin hydrochloride injection 10 mL added into 0.9％ Sodium chloride injection 500 mL， ivgtt. Observation group was given Entecavir maleate tablet 0.5 mg， po， qd， since 1 week before TACE， for 12 months. Clinical efficacy， the levels of AFP， ALT and HBV-DNA， daily life quality score and survival rate were observed in 2 groups， and the occurrence of ADR was recorded. RESULTS： Before treatment， there was no statistical significance in the levels of AFP， HBV-DNA and ALT， daily life quality score between 2 groups （P＞0.05）. After treatment， total effective rate of observation group was significantly higher than that of control group （41.54％ vs. 20.00％）， the levels of AFP， HBV-DNA and ALT in observation group were significantly lower than in control group， daily life quality score of observation group was significantly higher than that of control group， with statistical significance （P＜0.05）. The survival rate of 1， 2， 3 years follow-up in observation group were significantly higher than control group （75.38％ vs. 52.31％、53.85％ vs. 29.23％、32.31％ vs. 15.38％， respectively）， with statistically significance （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： For patients with hepatitis B secondary liver cancer， entecavir adjunctive treatment of during perioperative period of TACE can effectively control disease progression， protects the liver function， improves the quality of daily life and is helpful to extend the overall survival rate with good safety. |
| 期刊： | 2017年第28卷第2期 |
| 作者： | 胡兴龙，王胜智，康志龙，吴敏良，李志伟 |
| AUTHORS： | HU Xinglong，WANG Shengzhi，KANG Zhilong，WU Minliang，LI Zhiwei |
| 关键字： | 肝动脉化疗栓塞术；恩替卡韦；乙型肝炎；肝癌；肝功能 |
| KEYWORDS： | Transcatheter arterial chemoembolization； Entecavir； Hepatitis B； Liver cancer； Liver function |
| 阅读数： | 333 次 |
| 本月下载数： | 2 次 |
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