摘要【目的】探讨肝细胞肝癌（HCC）并肝硬化患者手术治疗的疗效、安全性、并发症及预后。【方法】以2001年1月至2008年8月在本院进行手术治疗的57例HCC并肝硬化患者为对象。采用回顾性分析方法，对患者治疗前后的资料进行整理分析，统计患者的年生存情况以及采用单因素与多因素回归分析方法探讨患者的年生存率相关影响因素。【结果】手术治疗后患者的1年生存率为63．6％，2年生存率52．1％，3年生存率34．7％，5年生存率19．3％。术前child分级，术前血小板计数，术前甲胎蛋白（AFP）计量，肿瘤组织大小以及是否进行根治性切除术与患者预后具有相关性（ P ＜0．05）。患者术前child分级与是否进行根治性手术是独立危险因素（ P ＜0．05）。【结论】手术是根治 HCC合并肝硬化的理想方法，但术前应准确评估患者的肝功能储备以及术后积极的辅助治疗是提高患者生存率和生活质量的关键。
Abstract：[Objective]To explore the efficacy ,safety ,complication and prognosis of surgical treatment of hepatocellular carcinoma(HCC) with liver cirrhosis .[Methods] Totally 57 HCC patients with liver cirrhosis undergoing surgical treatment in our hospital from Jan .2001 to Aug .2008 were enrolled in the study .A ret-rospective analysis method was used to analyze all data of patients before and after surgery .The year survival rate was calculated .Univariate and multivariate regression method was used to analyze the influencing factors of year survival rate of patients .[Results] The 1-year ,2-year ,3-year and 5-year survival rate of patients after surgery was 63 .6% ,52 .1% ,34 .7% and 19 .3% ,respectively .Preoperative child grading ,preoperative platelet count ,preoperative alpha-fetoprotein(AFP) measurement ,tumor size and whether radical resection or not were all correlated with the prognosis ( P<0 .05) .Preoperative child grading and whether radical surgery or not was an independent risk factor ( P <0 .05) .[Conclusion]Surgery is the ideal method of radical treat-ment of HCC with liver cirrhosis ,but accurate preoperative assessment of patients'liver functional reserve and postoperative active adjuvant therapy is the key to improve survival rate and quality life of the patients .
引用本文:
陈杰%钱立元. 影响肝细胞肝癌合并肝硬化手术疗效的单因素和多因素分析[J]. 医学临床研究, 2014, 31(4): 727-729.
CHEN Jie%QIAN Li-yuan. Univariate and Multivariate Analysis of the Efficacy of Surgical Treatment of Hepatocellular Carcinoma with Liver Cirrhosis. 医学临床研究, 2014, 31(4): 727-729.
2014, Vol. 31 
