广西医学

目的比较载药微球肝动脉化疗栓塞术（DEB⁃TACE）与常规肝动脉化疗栓塞术（C⁃TACE）治疗不可切除原发性肝癌（PLC）患者的近期疗效及安全性。方法回顾性分析60例不可切除PLC患者的临床资料，根据栓塞剂不同分为观察组（采用DEB⁃TACE）和对照组（采用C⁃TACE），各30例。比较两组患者术后3个月的疗效，术前及术后1个月的肝功能指标［血清ALT、AST、总胆红素（TBIL）、白蛋白（ALB）水平］，术前及术后3个月的甲胎蛋白（AFP）水平，以及术后不良反应和并发症发生情况。结果术后3个月，观察组的疾病客观缓解率高于对照组（P<0.05），但两组患者的疾病控制率差异无统计学意义（P>0.05）。术后3个月，两组患者的AFP水平较术前降低（P<0.05）；术前及术后3个月，两组患者之间的AFP水平比较，差异无统计学意义（P>0.05）。术后1个月，对照组的血清AST水平低于术前（P<0.05），两组患者的血清TBIL、ALB、ALT水平与术前比较，差异无统计学意义（P>0.05）；术前及术后1个月，两组患者之间的血清TBIL、ALB、ALT、AST水平比较，差异无统计学意义（P>0.05）。两组患者的术后不良反应及并发症发生率差异无统计学意义（P>0.05）。结论与C⁃TACE治疗相比，DEB⁃TACE治疗不可切除PLC患者的近期疗效更优，且安全性可控。

Objective To compare the short⁃term efficacy and safety of drug⁃eluting beads transcatheter arterial chemoembolization (DEB⁃TACE) versus conventional transcatheter arterial chemoembolization (C⁃TACE) in patients with unresectable primary liver cancer (PLC). Methods The clinical data of 60 patients with unresectable PLC were retrospectively analyzed. Based on the embolic agent used, patients were divided into observation group (employing DEB⁃TACE, n=30) or control group (employing C⁃TACE, n=30). The two groups were compared in terms of efficacy at 3 months post⁃surgery, liver function indicators with respect to serum ALT, AST, total bilirubin (TBIL), and albumin (ALB) levels before and 1 month after surgery, alpha⁃fetoprotein (AFP) level before and 3 months after surgery, as well as the occurrence status of postoperative adverse reactions and complications. Results At 3 months post⁃surgery, the objective response rate was higher in the observation group than in the control group (P<0.05), while no statistically significant difference was observed in the disease control rate between the two groups (P>0.05). At 3 months after surgery, AFP level decreased compared to pre⁃treatment level in both groups (P<0.05), but there was no statistically significant difference in AFP level between the two groups either before or 3 months after surgery (P>0.05). At 1 month post⁃surgery, serum AST level in the control group was lower than pre⁃treatment level (P<0.05). However, no statistically significant difference was observed in serum TBIL, ALB, or ALT levels compared to pre⁃treatment levels in either group (P>0.05). There was no statistically significant difference in serum TBIL, ALB, ALT levels, or AST level between the two groups before or 1 month after surgery (P>0.05). The incidence rate of postoperative adverse reactions and complications did not differ significantly between the two groups (P>0.05). Conclusion Compared with C⁃TACE, DEB⁃TACE demonstrates superior short⁃term efficacy in treating patients with unresectable PLC, with a controllable safety profile.