| 梅康,刘伟,张卫平,等.老年原发性肝癌患者综合介入治疗术后效果及其影响因素分析[J].中国临床保健杂志,2025,28(4):545-550. |
| 老年原发性肝癌患者综合介入治疗术后效果及其影响因素分析 |
| Analysis of efficacy after interventional comprehensive treatment and its influencing factors in elderly patients with primary liver cancer |
| 投稿时间：2025-04-17 |
| DOI：10.3969/J.issn.1672-6790.2025.04.021 |
| 中文关键词: 肝肿瘤 放射学,介入性 化学疗法,肿瘤,局部灌注 治疗结果 影响因素分析 老年人 |
| 英文关键词: Liver neoplasms Radiology,interventional Chemotherapy,cancer,regional perfusion Treatment outcome Root cause analysis Aged |
| 基金项目: |
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| 摘要点击次数: 9 |
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| 中文摘要: |
| 目的 探讨老年原发性肝癌患者综合介入治疗的效果,分析其影响因素。方法 回顾性研究。选取2023年1月至12月丽水市人民医院收治的86例行综合介入治疗术的老年原发性肝癌患者病历资料,纳入研究组；选取同期在同一医院行单纯肝动脉化疗栓塞术治疗的60例老年原发性肝癌患者作为对照组。收集患者的一般资料[性别、年龄、合并门静脉癌栓(PVTT)情况、肿瘤长径、肿瘤数目、肿瘤位置、肝炎类型、肝硬化情况]和实验室指标[甲胎蛋白(AFP)、白蛋白、丙氨酸转氨酶、天冬氨酸转氨酶],采用二元logistic回归模型分析老年原发性肝癌患者综合介入治疗术后效果及相关影响因素。结果 老年原发性肝癌患者综合介入治疗术后良好67例,不良19例,治疗有效率为77.91%,高于对照组(60.00%),P<0.05；不同疗效的老年原发性肝癌综合介入治疗术患者在合并PVTT、肿瘤长径、肿瘤数目、AFP水平比较,差异均有统计学意义(均P<0.05)；多因素logistic回归分析结果显示,PVTT、肿瘤长径、肿瘤数目、AFP均为老年原发性肝癌患者综合介入治疗术后效果的影响因素,有PVTT(OR=4.148,95%CI:2.005~8.586)、肿瘤长径≥6 cm(OR=3.743,95%CI:1.894~7.383)、多个肿瘤病灶(OR=3.640,95%CI:1.623~8.162)、AFP≥400 μg/L(OR=4.415,95%CI:2.060~9.463)的老年原发性肝癌患者经综合介入治疗预后不良风险更高(P<0.05)。结论 老年原发性肝癌患者行综合介入治疗的效果优于单纯肝动脉化疗栓塞术。老年原发性肝癌患者综合介入治疗的效果受PVTT、肿瘤大小、肿瘤数目和AFP水平的影响。 |
| 英文摘要: |
| Objective To explore the efficacy after interventional comprehensive treatment in elderly patients with primary liver cancer,and analyze its influencing factors.Methods Retrospective study.The medical data of 86 elderly patients with primary liver cancer who underwent comprehensive interventional treatment at Lishui People′s Hospital from January to December 2023 was recorded and used as the study group,while 60 elderly patients with primary liver cancer who received simple TACE treatment in the same hospital at the same time were selected as the control group.The general data [gender,age,portal vein tumor thrombus (PVTT) status,tumor diameter,tumor count,tumor location,hepatitis type,liver cirrhosis status]and laboratory indicators[alpha-fetoprotein (AFP),albumin,alanine aminotransferase,aspartate aminotransferase] were collected by talking with patients,viewing medical records and hospital HIS system.Binary logistic regression model was used to analyze the influencing factors of efficacy after interventional comprehensive treatment in elderly patients with primary liver cancer.Results There were 67 patients with good efficacy and 19 patients with poor efficacy after interventional comprehensive treatment in elderly patients with primary liver cancer,and the effective rate of treatment was 77.91%,and the total effective rate of treatment in the study group was 70.93%,which was higher than that in the control group (60.00%),P<0.05.Univariate analysis showed that there were statistically significant differences in PVTT,tumor diameter,tumor count and AFP level among elderly patients with primary liver cancer after interventional comprehensive treatment with different efficacies (P<0.05).Logistic multivariate analysis revealed that PVTT,tumor diameter,tumor count and AFP were the influencing factors of efficacy after interventional comprehensive treatment in elderly patients with primary liver cancer.The elderly patients with PVTT (OR=4.148,95%CI:2.005-8.586),tumor diameter ≥ 6 cm (OR=3.743,95%CI:1.894-7.383),multiple tumor lesions (OR=3.640,95%CI:1.623-8.162),and AFP≥400 μg/L (OR=4.415,95%CI:2.060-9.463) had higher risk of poor prognosis after interventional comprehensive treatment (P<0.05).Conclusions The effect of comprehensive interventional therapy on elderly patients with primary liver cancer is better than that of simple hepatic artery chemoembolization.The effectiveness of comprehensive interventional therapy for elderly patients with primary liver cancer is influenced by PVTT,tumor size,tumor number and serum AFP level. |
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