微球与碘油栓塞治疗大肝癌的疗效对比分析

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1、授予单位代码10089学号或申请号15364中国图书分类号R816.5HebeiMedicalUniversity硕士学位论文学术学位微球与碘油栓塞治疗大肝癌的疗效对比分析学位申请人：杨占辉导师：李智岗教授专业：影像医学与核医学二级学院：第四医院·目录中文摘要·····························································································1英文摘要·························

2、····································································3英文缩写·····························································································6研究论文微球与碘油栓塞治疗大肝癌的疗效对比分析前言·····························································

3、································7材料与方法·····························································································7结果·····························································································10附图······················

4、·······································································12附表·····························································································29讨论·················································································

5、············30结论·····························································································33参考文献·····························································································33综述TACE治疗原发性大肝癌的治疗进展························

6、·············35致谢·····························································································44个人简历·····························································································45微球与碘油栓塞治疗大肝癌的疗效对比分析摘要目的：比较碘油与微球栓塞大肝癌的临床疗效，

7、并讨论其影响预后的因素。方法：选择我院2012年11月份到2017年1月份32例中、晚期原发性大肝癌（肿瘤直径范围5~18.5cm）未经其他治疗的患者，其中碘油组15例：化疗药灌注+碘油的肝动脉化疗栓塞术；微球组17例：化疗药灌注+单纯微球的肝动脉化疗栓塞。栓塞术中化疗药物均采用顺铂、阿霉素、丝裂霉素。栓塞剂为碘化油、海藻酸钠微球（100~300um）。对介入栓塞前AFP，术后1个月AFP、术后并发症、生存情况进行随访评价两种栓塞剂疗效。短期疗效使用mRECIST标准：靶病灶的评价：①完全缓解（CR）

8、，所有靶病灶动脉期强化消失；②部分缓解(PR)，所有目标靶病灶最长径之和与基线状态比较，至少减少30%；③病变进展(PD)，靶病灶最长径之和与治疗开始之后所记录到的最小的靶病灶最长径之和比较，增加20%，并且长径总和和增加的绝对值在5mm以上或者出现一个或多个新病灶。④病变稳[1]定(SD)，介于部分缓解和疾病进展之间。术后一个月肿瘤坏死范围以肿瘤残存的影像学为标准：CT以动态增强扫描为标准，病灶在动脉期有明显强化，门脉期为低密度则诊断为有肿瘤残存。动脉