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《肝癌根治性切除術(shù)后早期復(fù)發(fā)的危險因素分析》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。
1、目錄縮略詞中英文對照表···································1中文摘要···············································2英文摘要···············································4引言·················································6正文·················································71.材料和方法···································
2、·······72.結(jié)果···············································93.討論·············································144.存在問題···········································315.結(jié)論·············································32參考文獻··············································33附錄······························
3、··················38綜述················································40致謝················································51攻讀學(xué)位期間發(fā)表的學(xué)術(shù)論文目錄···················52作者聲明··············································53個人簡歷··············································54縮略詞中英文對照表AbbreviationALTalaninetr
4、ansaminase丙氨酸氨基轉(zhuǎn)移酶ASTaspartatetransaminase天門冬酸氨基轉(zhuǎn)移酶AFPalphafetoprotein甲胎蛋白AFUalpha-L-fucosidaseα-L-巖藻糖苷酶CA19-9carbohydrateantigen19-9糖類抗原19-9CTcomputedtomographyX線計算機斷層掃描DCPdes-gamma-carboxy-prothrombin脫-γ-羧基凝血酶原GGTgammaglutamyltranspeptidaseγ-谷氨酰轉(zhuǎn)肽酶HBVhepaticBvirus乙型肝炎病毒HBsAghepatitisBsurfaceant
5、igen乙型肝炎表面抗體HCVhepaticCvirus丙型肝炎病毒ORoddsratio優(yōu)勢比PLCprimarylivercancer原發(fā)性肝癌SPSSStatisticalpackageforsocialscience社會科學(xué)統(tǒng)計軟件包1中文摘要目的：探討影響肝癌根治性切除術(shù)后早期復(fù)發(fā)的危險因素，明確影響肝癌根治性切除術(shù)后早期復(fù)發(fā)的獨立危險因素。方法：回顧性分析2006年7月1日至2008年10月31日期間收治的102例行肝癌根治性切除術(shù)并病理證實的原發(fā)性肝癌病歷資料，根據(jù)術(shù)后復(fù)發(fā)時間將全部資料分為早期復(fù)發(fā)組（術(shù)后1年內(nèi)有腫瘤復(fù)發(fā)）和非早期復(fù)發(fā)組（1年后復(fù)發(fā)或隨訪期間無復(fù)發(fā)），比較
6、可能對術(shù)后早期復(fù)發(fā)有影響的宿主、腫瘤及手術(shù)相關(guān)因素，包括性別、年齡、癥狀、乙肝表面抗原、肝硬化情況、術(shù)前肝功能Child-Pugh分級、術(shù)前血清AFP水平值、術(shù)前血清AST水平、腫瘤大小、腫瘤包膜、門靜脈癌栓、腫瘤分化程度、微血管浸潤、切緣距離、肝門阻斷時間、手術(shù)中輸血情況、手術(shù)持續(xù)時間、手術(shù)中總失血量等18項。結(jié)果：1.全組1年內(nèi)41例復(fù)發(fā)，復(fù)發(fā)率40.2%，早期復(fù)發(fā)組1年生存率為52.2%，2年生存率為13.4%。非早期復(fù)發(fā)組1年生存率和2年生存率分別為98.6%和90.5%。兩組間生存率比較，差異有統(tǒng)計學(xué)意義（P<0.01）。2.單因素分析結(jié)果顯示，早期復(fù)發(fā)組與非早期復(fù)發(fā)組比較，肝
7、硬化、腫瘤大小、腫瘤存在包膜、有門靜脈癌栓、腫瘤有微血管浸潤和術(shù)中總失血量6項因素存在差異，有統(tǒng)計學(xué)意義（P<0.05）；性別、年齡、癥狀、乙肝表面抗原、術(shù)前肝功能Child-Pugh分級、術(shù)前血清AFP水平、術(shù)前AST水平、腫瘤分化程度、切緣距離、肝門阻斷時間、手術(shù)中輸血情況、手術(shù)持續(xù)時間12項因素差異無統(tǒng)計學(xué)意義（P>0.05）。3.多因素分析表明，腫瘤大小、門靜脈癌栓、腫瘤微血管浸潤是影響肝癌早期復(fù)發(fā)的有統(tǒng)計學(xué)意義的因素（P<
