UNASSIGNED:探讨肝静脉压力梯度(HVPG)对肝癌经导管肝动脉化疗栓塞(TACE)后消化道出血的预测价值及早期经皮经肝动脉静脉曲张栓塞(PTVE)的疗效和意义。
UNASSIGNED:这项回顾性研究纳入了60例诊断为B期或C期肝癌的患者,根据巴塞罗那诊所肝癌(BCLC)分期系统,2019年12月至2021年10月。对所有60例患者进行TACE和HVPG测量(>16mmHg或>20mmHg),他们被随机分为对照组和实验组(PTVE)。所有患者均随访12个月。
UNASSIGNED:SPSS20.0软件用于数据分析。比较两组患者TACE术后出血的初始发生时间,出血复发时间,肝功能,TACE频率,TACE类型,和肿瘤控制。
未经证实:最初的出血率,三,六,TACE后12个月为3.2%,12.9%,22.6%,和48.4%,分别,对照组(n=31)和0%,0%,3.4%,和10.3%,分别,PTVE组(n=29)。两组术后6个月和12个月的初始出血率差异有统计学意义(P<0.05)。一次出血的复发率,三,六,TACE后12个月为11.1%,22.2%,22.2%,和33.3%,分别,对照组27例。在PTVE组的8名患者中,相应的比率为0%,0%,0%,和25.0%。4个时间点出血复发率组间差异均有统计学意义(P<0.05)。术后六个月,8例(25.8%)和18例(66.7%)患者肝功能恢复和缓解,分别,在对照组中;这些事件在10例(34.5%)和19例(65.5%)中被发现,分别,在PTVE组中,组间差异无统计学意义(P>0.05)。在对照组中,在12个月内对31例患者进行了94次TACE,包括常规经导管动脉化疗栓塞术(C-TACE,75.5%)和药物洗脱珠TACE(DEB-TACE,24.5%);客观缓解率(ORR)为39.3%。在PTVE组中,在12个月内对29例患者进行了151次TACE,每个病人平均5.21次,包括C-TACE(57.6%)和DEB-TACE(42.4%);ORR为60.1%。TACE频率的差异,C-TACE/DEB-TACE的比例,ORR与ORR比较差异有统计学意义(P<0.05)。
UNASSIGNED:HVPG可以准确评估肝癌患者TACE术后消化道出血。早期PTVE可以显着降低消化道出血的风险,并帮助TACE控制HVPG>16mmHg或>20mmHg的患者的肿瘤进展。
UNASSIGNED: To investigate the predictive value of hepatic venous pressure gradient (
HVPG) and the efficacy and significance of early percutaneous transhepatic varices embolization (PTVE) for gastrointestinal bleeding after transcatheter arterial chemoembolization (TACE) for liver cancer.
UNASSIGNED: This retrospective study enrolled 60 patients diagnosed with stage B or stage C liver cancer, according to the Barcelona Clinic Liver Cancer (BCLC) staging system, between December 2019 and October 2021. TACE and
HVPG measurement (>16 mmHg or >20 mmHg) were performed on all 60 patients, who were randomized into control and experimental (PTVE) groups. All patients were followed up for 12 months.
UNASSIGNED: SPSS 20.0 software was used for data analysis. The two groups were compared with respect to the initial occurrence time of hemorrhage after TACE, recurrence time of hemorrhage, liver function, TACE frequency, TACE type, and tumor control.
UNASSIGNED: The initial hemorrhage rates at one, three, six, and 12 months after TACE were 3.2%, 12.9%, 22.6%, and 48.4%, respectively, in the control group (n = 31) and 0%, 0%, 3.4%, and 10.3%, respectively, in the PTVE group (n = 29). Differences between the groups in terms of initial hemorrhage rate at six and 12 months postoperatively were significant (P < 0.05). The recurrence rates of hemorrhage at one, three, six, and 12 months after TACE were 11.1%, 22.2%, 22.2%, and 33.3%, respectively, in 27 patients in the control group. In eight patients in the PTVE group, the corresponding rates were 0%, 0%, 0%, and 25.0%. The differences between the groups in the recurrence rate of hemorrhage at the four time points were significant (P < 0.05). At six months postoperatively, liver function recovery and remission were noted in eight (25.8%) and 18 (66.7%) patients, respectively, in the control group; these events were noted in 10 (34.5%) and 19 patients (65.5%), respectively, in the PTVE group, and the difference between the groups was not significant (P > 0.05). In the control group, TACE was performed for a total of 94 times on 31 patients within 12 months, including conventional transcatheter arterial chemoembolization (C-TACE, 75.5%) and the drug-eluting bead TACE (DEB-TACE, 24.5%); the objective response rate (ORR) was 39.3%. In the PTVE group, TACE was performed for a total of 151 times on 29 patients within 12 months, with an average of 5.21 times on each patient, including the C-TACE (57.6%) and DEB-TACE (42.4%); the ORR was 60.1%. Differences in TACE frequency, proportion of C-TACE/DEB-TACE, and ORR were significant between the two groups (P < 0.05).
UNASSIGNED: HVPG can accurately evaluate gastrointestinal bleeding after TACE in patients with liver cancer. Early PTVE can significantly lower the risk of gastrointestinal bleeding and help TACE control tumor progression in patients with an
HVPG >16 mmHg or >20 mmHg.