TAE治疗肝癌破裂合并消融相关性出血的安全性评价及术后肝功能改变的临床意义。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-03-19 DOI:10.1016/j.transproceed.2025.02.043

Wenfeng Gao , Qing Zhang , Liang Ma , Ning He , Yonghong Zhang , Chunwang Yuan

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引用次数: 0

摘要

目的：评价经动脉栓塞（TAE）治疗肝癌破裂出血与消融后出血的安全性，比较术后肝功能指标如丙氨酸转氨酶（ALT）、总胆红素（TBIL）、凝血酶原时间百分比（PT%）。方法：回顾性分析破裂出血组、消融后出血组和对照组（常规TAE）患者手术前后肝功能的变化。通过比较术前术后ALT、TBIL、PT%水平，采用ROC曲线分析评价TAE的安全性。结果：所有患者均顺利完成手术，止血成功率100%。破裂组30天生存率为90.91%，消融组为100%，1年生存率分别为45.45%和85.19%。各组间ALT、TBIL术前、术后均有显著变化，但与对照组比较无显著差异。ROC分析显示ALT和TBIL升高对肝损伤有很强的预测价值。结论：TAE是一种安全有效的治疗肝癌破裂出血及消融后出血的方法。这些组的术后肝功能变化与对照组相当。监测ALT和TBIL对于早期发现肝损伤，及时干预至关重要。这些发现加强了TAE方案和肝脏保护策略，改善了肝癌患者的预后。

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The Safety Evaluation of TAE for Ruptured Hepatocellular Carcinoma and Ablation-Related Hemorrhage, and the Clinical Significance of Postoperative Liver Function Changes

Objective

This study evaluates the safety of transarterial embolization (TAE) for treating ruptured hemorrhage in liver cancer and postablation bleeding, comparing postoperative liver function indicators such as alanine aminotransferase (ALT), total bilirubin (TBIL), and prothrombin time percentage (PT%).

Methods

A retrospective analysis was conducted on liver function changes before and after surgery in 3 patient groups: ruptured hemorrhage, postablation bleeding, and a control group (routine TAE). The safety of TAE was assessed by comparing preoperative and postoperative levels of ALT, TBIL, and PT%, using ROC curve analysis to evaluate predictive values for liver injury.

Results

All patients successfully underwent surgery, with a 100% hemostasis success rate. The 30-day survival rates were 90.91% for the rupture group and 100% for the ablation group, while 1-year survival rates were 45.45% and 85.19%, respectively. Significant pre- and postoperative changes in ALT and TBIL were found within groups, but no significant differences were observed compared to the control group. ROC analysis showed strong predictive values for ALT and TBIL increases regarding liver injury.

Conclusion

TAE is a safe and effective treatment for ruptured hemorrhage and post-ablation bleeding in liver cancer. Postoperative liver function changes in these groups are comparable to controls. Monitoring ALT and TBIL is crucial for early detection of liver injury, informing timely interventions. These findings enhance TAE protocols and liver protection strategies, improving outcomes for liver cancer patients.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.