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经动脉化疗栓塞治疗肝细胞癌后发热:发生率及危险因素分析

Fever after transcatheter arterial chemoembolization for hepatocellular carcinoma: incidence and risk factor analysis.

作者信息

Li Chung-Pin, Chao Yee, Chen Li-Tzong, Lee Rheun-Chuan, Lee Wei-Ping, Yuan Jeng-Nian, Yen Sang-Hue, Lee Shou-Dong

机构信息

Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Scand J Gastroenterol. 2008 Aug;43(8):992-9. doi: 10.1080/00365520801971744.

DOI:10.1080/00365520801971744
PMID:19086281
Abstract

OBJECTIVE

Post-treatment fever frequently occurs in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE), but its incidence and clinical significance are unclear. The aim of this study was to identify the incidence and risk factors for fever after TACE in HCC patients.

MATERIAL AND METHODS

Forty-one consecutive HCC patients undergoing 73 sessions of TACE were included in the study. The incidence and possible risk factors associated with post-TACE fever were analyzed.

RESULTS

Forty-nine (67%) episodes of fever developed in 30 (73%) HCC patients after TACE, but none of the patients developed bacterial infection after TACE. Patients who developed fever were of younger age, had larger tumors, a higher dose of chemoembolization agents and a higher embolized volume compared with those without fever. Multivariate logistic regression disclosed that a dosage of doxorubicin plus iodized oil > 23 during chemoembolization and tumor size > 3 cm were significant predictors associated with the development ofpost-TACE fever (odds ratio: 3.749, 95% CI: 1.188-11.830, p = 0.024 and odds ratio: 3.599, 95% CI: 1.107-11.706, p = 0.033, respectively).

CONCLUSIONS

Fever after TACE is common, but infectious complications are rare. Chemoembolization dosage and tumor size are predictive of fever after transcatheter arterial chemoembolization and may be of help in the prevention and care of this distressing complication.

摘要

目的

经动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)后,治疗后发热较为常见,但其发生率及临床意义尚不清楚。本研究旨在确定HCC患者TACE术后发热的发生率及危险因素。

材料与方法

本研究纳入了41例连续接受73次TACE治疗的HCC患者。分析了TACE术后发热的发生率及可能的危险因素。

结果

30例(73%)HCC患者TACE术后出现49次(67%)发热,但无一例患者TACE术后发生细菌感染。与未发热患者相比,发热患者年龄较轻、肿瘤较大、化疗栓塞剂剂量较高且栓塞体积较大。多因素logistic回归分析显示,化疗栓塞期间阿霉素加碘化油剂量>23以及肿瘤大小>3 cm是TACE术后发热的显著预测因素(比值比分别为:3.749,95%可信区间:1.188 - 11.830,p = 0.024;比值比为:3.599,95%可信区间:1.107 - 11.706,p = 0.033)。

结论

TACE术后发热常见,但感染性并发症罕见。化疗栓塞剂量和肿瘤大小可预测经动脉化疗栓塞术后发热,可能有助于预防和处理这一令人困扰的并发症。

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