| Objectives :To investigate the changes of liver function and complications in patients with primary hepatocellular carcinoma treated with adjuvant transhepatic arterial intervention after hepatectomy,and to search for high-risk patients who may have abnormal liver function and complications after surgery,so as to provide a clinical basis for the decision of adjuvant treatment after hepatectomy.Methods: Seventy-nine patients admitted to the First People’s Hospital of Kunming from January 2017 to January 2022 with primary hepatocellular carcinoma treated with adjuvant hepatic artery intervention after left hemihepatectomy were collected.Retrospective analysis of the effects of adjuvant hepatic arterial intervention after hepatectomy on liver function and risk factors for complications.Results:(1)RBC,Hb,PLT,LYMPH,TP,GLB,ALB,TT were significantly lower than before treatment(P<0.05),while WBC,NEUT,TBIL,DBIL,IBIL,ALT,AST,PT were significantly higher than before treatment after adjuvant hepatic artery intervention(P<0.05).(2)The difference in abnormal liver function before and after adjuvant hepatic artery intervention was statistically significant(P<0.05),and the difference in the change of liver function Child classification was not statistically significant(P>0.05).Patients with abnormal liver function before treatment were more likely to have vomiting and pain in the liver area(P<0.05).(3)Univariate analysis of abnormal liver function after adjuvant hepatic arterial intervention after hepatectomy showed that Hb,TBIL,DBIL,IBIL,chemotherapy drug regimen,and calcium folate use were associated with abnormal liver function after hepatic arterial intervention(P<0.05).Multifactorial logistic analysis showed that IBIL(OR=1.562,95% CI: 1.150-2.124,P=0.004),oxaliplatin(OR=0.23,95% CI: 0.057-0.923,P=0.038),non-use of calcium folinic(OR=5.549,95% CI: 1.271-24.227,P=0.023)were independent risk factors for abnormal liver function after adjuvant hepatic artery intervention.The higher the value of IBIL,the higher the risk of abnormal liver function after treatment.Patients who use oxaliplatin were more likely to have abnormal liver function than patients who use lobaplatin.The use of calcium folinate in perfusion therapy could reduce the occurrence of abnormal liver function.(4)The area under the curve of the ROC curve drawn for the assessment of liver function abnormalities was 0.877(95% CI: 0.787-0.967,P<0.001).The maximum of the Jorden index was 0.653,at which time the sensitivity of the model was 77.4% and the specificity was 87.9%.Conclusions:(1)The first auxiliary hepatic artery interventional therapy will cause early mild and moderate liver function damage.(2)Patients with abnormal liver function before adjuvant hepatic artery intervention are more likely to have vomiting and pain in the liver area.(3)IBIL,oxaliplatin,and non-use of calcium folinic are independent risk factors for abnormal liver function after adjuvant hepatic motility interventions.(4)The development of a regression prediction model for liver function abnormalities has some value in predicting liver function abnormalities after adjuvant hepatic artery interventions. |
