目的：探讨经动脉化学治疗栓塞术（TACE）联合高强度聚焦超声（HIFU）对比单一 TACE 治疗老年（年龄大于或等于60岁）原发性肝癌的临床疗效。方法回顾性分析重庆医科大学附属第二医院72例老年原发性肝癌患者的临床资料，按治疗方式分为 TACE 联合 HIFU 治疗组（联合组，n＝36）与 TACE 治疗组（TACE 组：n＝36），比较两组治疗后肿瘤缩小情况，甲胎蛋白（AFP）水平及肝功能变化，中位生存时间，1、2、3年生存率等指标。结果联合组较 TACE 组肿瘤缩小更明显（P＜0．05），术后AFP 值减小更多（P＜0．05）；联合组及 TACE 组中位生存时间，1、2、3年生存率分别为：（32．0±6．9）个月、83．1％、57．3％、42．6％和（21．0±6．3）个月、62．9％、41．4％、22．3％，联合组中位生存时间及各对应时间点生存率较 TACE 组高（P＜0．05）；两组术后均无严重并发症。结论 TACE 联合 HIFU 治疗老年原发性肝癌是安全、有效的，较单一 TACE 治疗更能使老年肝癌患者获益。%Objective To evaluate clinical therapeutic efficacy of transarterial chemotherapy embolization (TACE) combined with high intensity focused ultrasound (HIFU ) compared with single TACE for treating elder patients ( ≥ 60 years old) with pri-mary liver cancer .Methods Clinical data of 72 elderly patients with primary liver cancer in the Second Affiliated Hospital of Chongqing Medical University were retrospectively analyzed .They were divided into TACE combined with HIFU group (combina-tion group :n= 36) and TACE group (TACE group :n= 36) according to the treatment .Compared tumor shrunk ,the change of AFP value and liver function ,median survival time ,1 year ,2 years ,3 year survival rates in two groups .Results The degree of tumor shrunk in combination group were more significant than that of TACE group (P< 0 .05) ,meanwhile ,AFP value decreased more in combination group (P< 0 .05) .Median survival time in combination and TACE group ,the 1 year ,2 years ,3 year survival rates were (32 .0 ± 6 .9) months ,83 .1% ,57 .3% ,42 .6% and (21 .0 ± 6 .3) months ,62 .9% ,41 .4% ,22 .3% respectively ,as compared with the TACE group ,the combination group had a higher survival rate (P< 0 .05) .There were no severe complications in both groups .Con-clusion The treatment of TACE combined with HIFU is effective and safe for treating elder patients with primary liver cancer and can make more clinical benefits compared with single TACE .
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