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目的:评价肝动脉化疗栓塞术(TACE)与支持疗法联用对伴乙肝病毒(HBV)感染中晚期原发性肝癌(PLC)患者的临床疗效。方法:选取2010年8月—2012年12月间诊治的HBV感染伴中晚期PLC患者74例,将其随机分为观察组与对照组(每组37例),对照组患者给予支持疗法治疗,观察组患者给予TACE与支持疗法方案治疗,比较两组患者1年后HBV-DNA转阴率、1月后短期疗效、2年内存活情况及不良反应发生情况。结果:观察组患者HBV转阴率为48.65%与对照组为51.35%比较其差异无统计学意义(P>0.05);观察组患者1年内总控制率为89.19%,显著高于对照组为67.57%(P<0.05);观察组患者2年后存活率为37.82%,显著高于对照组为10.84%(P<0.05);观察组患者不良反应的发生率显著高于对照组(P<0.05),但其不良反应均较轻微,经对症治疗后缓解。结论:TACE与支持治疗联用对伴HBV感染中晚期PLC患者疗效显著,且不良反应轻微,安全性较高。
Objective: To evaluate the clinical efficacy of transcatheter arterial chemoembolization (TACE) in combination with supportive therapy for patients with advanced primary hepatocellular carcinoma (PLC) who have acquired hepatitis B virus (HBV) infection. Methods: Seventy-four patients with HBV infection and intermediate-advanced PLC who were diagnosed and treated between August 2010 and December 2012 were randomly divided into observation group and control group (37 cases in each group), patients in control group were given supportive therapy, Patients in the observation group were treated with TACE and supportive therapy regimen. HBV-DNA negative conversion rate, short-term efficacy after 1 month, survival within 2 years and adverse reactions were compared between the two groups after 1 year. Results: The negative control rate of HBV in the observation group was 48.65% compared with 51.35% in the control group (P> 0.05). The total control rate in the observation group was 89.19% within one year, which was significantly higher than that of the control group % (P <0.05). The survival rate of observation group after 2 years was 37.82%, which was significantly higher than that of control group (P <0.05). The incidence of adverse reactions in observation group was significantly higher than that of control group (P <0.05) ), But the adverse reactions were mild, relieved after symptomatic treatment. Conclusion: The combination therapy of TACE and supportive therapy has significant curative effect on PLC patients with advanced HBV infection in middle and late stage, with mild adverse reactions and high safety.