探讨氩氦刀冷冻消融联合经导管动脉化疗栓塞术(TACE)治疗巨大肝癌临床效果以及对患者免疫功能的影响。

回顾性分析2016年11月至2020年5月92例巨大肝癌患者资料，根据治疗方法不同分为联合组和TACE组，TACE组(n＝48)采用单纯TACE治疗，联合组(n＝44)采用TACE联合氩氦刀冷冻消融治疗。用SPSS 22.00统计软件进行数据分析，免疫功能等计量资料用(±s)表示，采用独立t检验，疗效比较采用秩和检验；并发症比较采用χ²检验，总生存率采用Kaplan-Meier法进行生存分析。P<0.05差异有统计学意义。

联合组总有效率显著高于TACE组(P<0.05)；治疗后1个月，联合组免疫功能指标均优于TACE组(P<0.05)；联合组并发症总发生率为36.4%(16/44)，TACE组39.6%(19/48)，差异无统计学意义(P>0.05)；联合组1、2、3年的生存率分别为81.8%、56.8%、36.4%明显高于TACE组总生存率60.4%、35.4%、14.6%，差异均有统计学意义(P<0.05)。

氩氦刀冷冻消融联合TACE治疗巨大肝癌安全有效，相比于单纯TACE治疗，可有效改善患者的免疫功能，提高患者的生存率，值得临床推广。

To investigate the clinical outcome of argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in the treatment of huge hepatocellular carcinoma (HCC) and to evaluate its effect on the immune function of patients.

From November 2016 to May 2020, a retrospective analysis was performed in 92 patients with huge liver cancer. According to the treatment methods, 48 cases were divided into the TACE group who were treated with TACE alone, and 44 cases were divided into combined group who were treated with TACE combined with argon-helium knife cryoablation. Statistical analysis were performed by using SPSS 22.00 software. Measurement data such as immune function were expressed as (±s), and were examined by the independent t test, while curative effect were compared by using rank and inspection. The complications were compared by using χ² test, and the overall survival rate was analyzed by using Kaplan-Meier method. A P value of <0.05 was considered as statistically significant difference.

The total effective rate of the combined group was significantly higher than that of the TACE group (P<0.05). One month after treatment, the immune function indexes of the combined group were better than those of the TACE group respectively (P<0.05). The total incidence of complications in the combined group was 36.4% (16/44) and 39.6% (19/48) in the TACE group, with no statistically significant difference (P>0.05). The 1, 2, and 3 year survival rates were 81.8%, 56.8%, and 36.4% in the combined group respectively. and the 1, 2, and 3 year survival rates were 60.4%, 35.4%, and 14.6% in the TACE group respectively, with statistically significant difference between two groups (P<0.05).

Argon-helium cryoablation combined with TACE is safe and effective in the treatment of huge liver cancer. Compared with TACE alone, it could effectively improve the immune function of patients and improve the survival rate of patients, which is worthy of clinical promotion.