| 肝癌的射频消融治疗及核苷类药物辅助治疗的循证研究 |
| Alternative Title | The Evidence-based Study on Therapies of Liver Cancer with Radiofrequency Ablation and The Adjuvant Therapy with Nucleotide/Nucleoside Analogs
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| 夏博伟 |
| Thesis Advisor | 何晓东
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| 2015-05-21
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 博士
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| Keyword | 肝癌
射频消融
核苷类药物
系统评价
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| Abstract | 【目的】对RFA治疗HCC的临床一级证据进行归纳整理和简要总结、评估，并对RFA或与RFA相关的治疗联合或辅助其他方法治疗HCC存在的争议性临床议题，通过循证医学研究方法进行研究分析并得出结论。【方法】数据库检索RFA治疗HCC的临床一级证据文献并进行归纳整理和综合评估，在现有证据基础上对HCC治疗相关的具有争议性的两个临床议题运用系统评价或meta分析的方法进行研究分析。【结果】通过检索及分析我们制订了三个部分的研究题目，结果表明：单独RFA治疗对比PEI对于直径小于5 cm的HCC具有统计学疗效优势，RFA联合其他治疗（经动脉化疗栓塞（TACE）或全身化疗等）对比单独RFA治疗对于直径大于3 cm的HCC具有统计学疗效优势；RFA联合PEI的治疗手段在提高HCC患者生存率、降低肿瘤局部复发率方面明显优于RFA单独治疗手段；治愈性治疗后给予核苷类抗病毒药物治疗可以显著提高HBV相关性HCC患者的生存率，并降低早期肿瘤复发率。【结论】RFA对于直径小于3 cm的HCC单独治疗可以达到较高疗效，联合治疗已无必要；对于直径大于3 cm的HCC，联合其他治疗可以提高RFA疗效；对于乙型病毒性肝炎（HBV）相关性HCC患者，在行RFA、PEI或手术切除等治愈性治疗后给予核苷类抗病毒药物的辅助治疗在改善患者预后方面可以获得明显收益。 |
| Other Abstract | Aims:To review,summary and evaluate the high-quality clinical evidences on the therapies of HCC with RFA.Methods:We reviewed and evaluated the high-quality clinical studies on the therapies of HCC with RFA.Results:RFA has significant benefit for patients with HCC less than 5.0 cm in diameter when compared with PEI.Combination of RFA with other therapies could improve overall survival and reduce recurrence of patients with HCC larger than 3.0 cm in diameter;RFA combined with PEI could significantly improve the survival and the local recurrence of patient with HCC compared with RFA alone;antiviral therapy with nucleotide/nucleoside analogs (NA) could improve survival and reduce early recurrence for patients with HBV-related HCC after curative treatment.Conclusions:For HCC less than 3.0 cm in diameter, RFA alone could achieve in a better efficacy;however, for HCC larger than 3.0 cm in diameter, the treatment of RFA combined with other therapy could get a better effect than RFA alone; antiviral therapy with NA could significantly benefit the patients with HBV-related HCC after curative treatment such as RFA, PEI or hepatic resection. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223486
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
夏博伟. 肝癌的射频消融治疗及核苷类药物辅助治疗的循证研究[D]. 兰州. 兰州大学,2015.
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