Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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The Analysis of the Causes of Prolonged Hospitalization after Transarterial Chemoembolization in Patients with Unresectable Hepatocellular Carcinoma

수술적 절제가 어려운 간암환자에서 간동맥화학색전술 후 장기입원을 야기하는 원인인자에 대한 분석

  • Park, Seo-Yeon (Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Chang, Nam-Kyu (Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital) ;
  • Kim, Jae-Kyu (Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Jeong, Yong-Yeon (Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital)
  • 박서연 (전남대학교병원 영상의학과, 전남대학교 의과대학 영상의학과교실) ;
  • 장남규 (화순전남대학교병원 영상의학과, 전남대학교 의과대학 영상의학과교실) ;
  • 김재규 (전남대학교병원 영상의학과, 전남대학교 의과대학 영상의학과교실) ;
  • 정용연 (화순전남대학교병원 영상의학과, 전남대학교 의과대학 영상의학과교실)
  • Published : 2011.01.01
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Abstract

Purpose: We wanted to analyze the causes of prolonged hospitalization (over 7 days) after transarterial chemoembolization (TACE) in patients with unresectable Hepatocellular Carcinoma and its related factors. Materials and Methods: We analyzed the total hospital days after patients with unresectable Hepatocellular Carcinoma received transarterial chemoembolization, and these patients were treated during the recent 6 month at our hospital. Two hundred twenty three sessions showed a short term hospital stay (less than 7 days) and 57 sessions showed a prolonged hospital stay (more than 7 days), so a total of 280 sessions were analyzed. The hospital stay less than seven days was set for the control group and this was correlated with the patient's age, gender, the level of bilirubin and albumin, the platelet counts, the AST/ALT ratio, the a-FT, the presence of portal vein thrombosis and ascites, several scoring systems (Child-Pugh, CLIP, and OKUDA score) and the need for additional embolization at the time of the procedure. Results: Compared with that of the control group, ascites (p=0.004), portal vein thrombosis (p=0.000), a platelet count below the hundred thousand (p=0.012), a Child-Pugh score more than B (p=0.023), a CLIP score more than 2 (p=0.000) and a OKUDA score more than II (p=0.000) showed significant differences. Conclusion: The evaluation of patients' factors would be useful to predict extended post-procedural hospitalization after hepatic chemoembolisation.

목적: 수술적 절제가 어려운 간세포 암으로 간동맥화학색전술을 시행한 환자군에서 총 입원기간이 일주일 이상으로 장기입원이 필요했던 경우를 분석하여 이와 관련된 환자인자를 알아보고자 하였다. 대상과 방법: 최근 6개월 동안 간동맥화학색전술을 시행한 환자들의 재원기간을 조사하여 7일 미만인 223건과 7일 이상이었던 57건을 대상으로 하여 총 280건을 조사하였다. 재원기간이 7일 미만이었던 경우를 대조군으로 설정하고 7일 이상이었던 경우와 환자의 나이, 성별, 빌리루빈, 알부민, a-FT수치, 혈소판수치, AST/ALT, 간문맥분지 혈전증과 복수의 존재 유무와, Child-Pugh 점수, CLIP 점수, OKUDA 점수, 그리고 시술 시에 추가했던 색전술 시행 여부와의 관련성을 알아보았다. 결과: 재원기간이 7일 이상으로 증가되었던 경우는 복수(p=0.004)와 간문맥분지 혈전증 (p=0.000)이 있고, platelet 수치 10만 이하(p=0.012), Child 점수 B이상(p=0.023), CLIP 2점 이상(p=0.000), OKUDA II 단계이상(p=0.000)인 경우가 대조군과 비교하여 의의 있는 차이를 보였다. 결론: 간동맥화학색전술을 시행한 후 장기입원을 예측할 수 있는 여러 인자들을 충분히 고려해야 한다.

Keywords

References

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