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摘要：
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摘要：目的 探讨Child-Pugh分级对经肝动脉化疗栓塞（transcatheter arterial chemoembolization，
TACE）联合射频消融术（radiofrequency ablation，RFA）治疗的肝细胞癌（hepatocellular carcinoma，
HCC）患者预后的影响。方法 选取2012年2月至2014年11月在陕西省第四人民医院行TACE联合RFA
治疗的HCC患者，其中Child-Pugh A级48例，Child-Pugh B级50例。评估所有患者术后12个月Child-
Pugh评分变化以及术后3年的生存时间和复发率。结果 TACE联合RFA术后Child-Pugh A级HCC患者的
Child-Pugh评分低于治疗前（t = 4.791，P ＜ 0.001），而Child-Pugh B级患者与治疗前相比差异无统计
学意义（t = 1.635，P = 0.109）。Child-Pugh A级HCC患者3年生存期和复发率与Child-Pugh B级患者差
异无统计学意义（χ 2 = 1.836，P = 0.175；χ 2 = 2.696，P = 0.101），但生存期曲线和复发率曲线已呈现
差异趋势，且Child-Pugh A组患者生存率趋向更高，复发率趋向更低。结论 TACE联合RFA术治疗早
期HCC患者，可在基线肝功能较好（Child-Pugh评分5～8分）的患者中获得更好的预后。
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Abstract: Objective To investigate the effects of Child-Pugh grade on the prognosis of patients with
hepatocellular carcinoma (HCC) treated by transcatheter arterial chemoembolization (TACE) combined with
radiofrequency ablation (RFA). Methods Patients with HCC who underwent TACE combined with RFA in
the Fourth People’s Hospital of Shaanxi Province from February 2012 to November 2014 were selected. Total
of 48 cases were Child-Pugh A grade and 50 cases were Child-Pugh B grade. Child-Pugh score after one year,
3 years’ survival time and recurrence rate of the patients were evaluated. Results After TACE combined RFA
therapy, Child-Pugh scores of patients with Child-Pugh A grade were significantly lower than those before
treatment (t = 4.791, P ＜ 0.001). However, no difference on Child-Pugh scores were found in patients with
Child-Pugh B grade before and after treatment (t = 1.635, P = 0.109). Although no difference in 3 years’
survival rate and recurrence rate between patients with Child-Pugh A grade and B grade (χ 2 = 1.836, P = 0.175;
χ 2 = 2.696, P = 0.101), but the difference emerged expanding trend, which showed higher 3 years’ survival
rate and lower recurrence rate in patients with Child-Pugh A grade. Conclusions Better prognosis of TACE
combined RFA therapy on patients with HCC are more likely to be found in those patients with low Child-
Pugh score (5～8).
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