The Curative Effect Of Percutaneous Hepatic Arterial Chemoembolization In The Treatment Of Liver Cancer

ObjectiveTo explore the curative effect and prognostic factors of hepatic arterial chemoembolization in patients with advanced hepatocellular carcinoma.To observe the changes of the blood supply artery in the patients with multiple chemoembolization of the tumor to guide the arterial embolization method;To observe TCM syndromes before and after chemoembol ization The changes will guide the dialectical use of Chinese medicine in the intervention process in order to increase the comprehensive clinical efficacy of patients with liver cancer.Methods1.A retrospective analysis in January 2010-January 2018 in the first affiliated hospital of guangzhou university of TCM oncology center line of the hepatic artery embolism chemotherapy of the clinical data of 100 cases of primary liver cancer patients and follow-up data,all of the patients STATA13.0 data application software for statistical analysis.Kaplan-meier method was used to calculate the survival rate,and log-rank method was used to test the differences between the groups in survival time.Cox regression was used for multivariate analysis,and the factors affecting the prognosis and efficacy were screened out.2.After the postoperative CT observat ion,the blood supply changes of t he tumor and iodine oil deposit ion were observed after multiple TACE surgery,and the tumor blood supply was used to test the correlation between the number of tumor blood supply and the number of treatments and the embolization agent.To test the relationship between iodine oil deposition and embolization agent.3.To observe the distribution and dynamic changes of TCM syndrome before and after TACE.Count data using X2 test or Fisher test.Results1.Nine factors that may influence prognosis were analyzed by univariate on age,tumor type,AFP level,portal vein tumor thrombus,treatment frequency,treatment method,Child-pugh liver function grade,preoperative metastasis,and embolization agent selection.Age,tumor type,number of treatments,treatment methods,Child-pugh liver function classification,portal vein tumor thrombus,AFP level,preoperative metastasis,and embolization agents were all associated with prognosis(P<0.05).Multivariate analysis:Multiple cox models were introduced to screen for prognostic factors.The results showed that portal cancer thrombosis and Child-pugh grading of liver function were significantly associated with prognosis(P<0.05).2.82 cases were included in the inclusion criteria,of which 70 patients received two or more TACE treatments,and 29 cases were presented with side blood donors.The incidence of interventional therapy vs.3-4 treatment vs.5 was 17.6%vs.53.5%vs.70%.The relationship between the positive rate of blood supply and the number of embolism was verified by the chi-square test,and the results indicated that the increase of the number of embolization resulted in the increase of the positive rate of the collateral circulation.Using chi-square test to analyze the postoperative iodine oil deposition in each embolization group,it was shown that the iodine oil deposition in the comprehensive embolization group was significantly better than that of the pure iodine oil group.3.Before and after interventional treatment,there was a statistically significant difference in the distribution of TCM syndromes(P<0.05).After interventional intervention,there was a significant decrease in syndromes of stagnation of liver-qi and spleen,and a marked increase in syndromes of dampness of liver and gallbladder and syndromes of spleen-deficiency and dampness.The difference was statistically significant(P<0.05).Conclusion1.Hepatic arterial chemoembolization is one of the important treatment methods for patients with advanced liver cancer.For patients with good liver function classification,patients with no portal vein tumor thrombus have a better prognosis.2.Recurrence and metastasis after liver cancer intervention is related to the formation of the collateral circulation in the lesion and the difference in iodine oil deposition in the lesion.The deposition of iodine oil was related to the choice of embolic agent.3.TACE after TACE is based on syndrome of liver and gallbladder damp heat syndrome and spleen deficiency wet syndrome,suggesting that traditional Chinese medicine syndrome differentiation and treatment of heat and dampness,spleen Qi for the main rule.