Adverse Reactions And Its Influencing Factors In The Therapy Of Primary Liver Cancer After Transcatheter Arterial Chemoembolization

Objective To evaluate the security of TACE in the therapy of primary liver cancer and discuss the incidence and influence factors of adverse reactions, which can offer the prevention basis to implement TACE safely and effectively.Methods We have observed the postoperative complications and the incidence of adverse reactions of the 206 patients who have been subjected to receive TACE. The 206 patients came from the Infectious Diseases, Interventional Radiology and Gastroenterology of the First Affiliated Hospital of Bengbu Medical College. We have Monitored the blood, the renal and liver function on the 3th and 30th days after TACE.A Logistic retrospective analysis on multiple risk factors were made by the incidence of adverse reactions.Results There were 206 patients who had been subjected to receive TACE. There were 172 patients appeared adverse reactions, and the incidence of adverse reactions is 83.5%.The main adverse reactions principally included 154 patients (154/206,74.76%) of hepatic function damage,152 patients (152/206,73.79%) of hepatalgia and abdominal pain,150 patients (150/206,72.82%) of nausea and vomit,116 patients (116/206,56.31%) of abdominal distension,52 patients (52/206,25.24%) of fever and the whole body skin reaction were 30 patients (30/206,14.56%) and so on.Only a few pations can suffer from diarrhea (24.37%) and constipation.Above-mentioned adverse reactions were little serious to the body,and their severity level mostly was Ⅱ and Ⅲ degree.These adverse reactions mostly began on lth to 3th days after TACE and returned to pretreatment levels after symptomatic treatment.The serious adverse reactions of those include upper gastrointestinal hemorrhage were 6 patients (6/206,2.9%),8 (8/206,3.83%) of uroschesis,3 patients of ruptured liver cancer with hemorrhage and so on. These of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), white blood cell (WBC) on 3th after TACE were apparently higher than that in preoperation(41.3±26.4 VS 105.5±74.6U/L;61.4±42.14 VS 115.8±68.46U/L;16.77±9.66 VS 29.2±19.09umol/L; 5.4±2.19×109/L VS 6.514±3.42×109/L; P<0.05).However the albumin (ALB), cholinesterase (CHE), red blood cell (RBC), platelets (PLT) were significantly lower than the preoperative (36.71±5.16 VS 35.19±6.76g/L; 5311.9± 2003.57 VS 4448.17±1980.83U/L; 4.4±78x1012/L VS 4.11±0.65×1012/L; 158.14 ±96.56×109/L VS 138.1±78.46×109/L, P<0.05),and the glutamyl transferase (γ-GT), alkaline phosphatase (ALP) compared with preoperative were no significant difference (P> 0.05).The ALT, AST, TBiL, CHE, ALB, RBC, PLT returned to preoperative levels (P> 0.05) on 30th after TACE. There are high risk of adverse reactions of patients who combined with cirrhosis, the inferior vena cava or (and) portal vein tumor thrombus occurs, Child B grade, Bclc C period and lipiodol dose≥10ml, messive hepatocellular carcinoma(P<0.05).Conclusion 1, With a higher incidence of adverse reactionsafterTACE, the mojority of the patients have a slight degree of damage (mainly I to grade Ⅲ, mostly reversible). The adverse reactions began on 1th to 3th days after TACE and returned to pretreatment levels after symptomatic treatment. So TACE represents a safe therapeutic altemative for primary liver cancer.2, There are high risk of adverse reactions of patients who combined with cirrhosis, the inferior vena cava or (and) portal vein tumor thrombus occurs, Child B grade, Bclc C period and lipiodol dose≥10ml, messive hepatocellular carcinoma. So these patients should be strict preoperative assessment. If necessary, they would be symptomatic and supportive treatment line before TACE and a close observation of clinical surgery is necessary after TACE.