中文摘要：

目的探讨TACE联合下腔静脉放射性支架植入治疗肝细胞肝癌伴下腔静脉癌栓的安全性及有效性。方法对61例肝细胞肝癌伴下腔静脉癌栓患者的资料行回顾性分析，放射性支架采用^125I粒子条捆载裸支架的方法，共对33例患者采用此方法（A组），28例患者植入裸支架（B组）。采用倾向性评分匹配（propensity score matching）对原数据进行后随机化分析以减少选择性偏倚，对两组患者的生存期，症状缓解率及不良反应进行对照分析。结果两组患者术后不良反应发生率相仿，均采用内科对症处理。A组患者较B组显示更长的生存期优势，A组中位生存时间（203．0±28．1）d，B组（93．0±24．3）d（P=0．006），倾向性评分匹配后（24对）A组（200±31）d，B组（66．0±23）d（P=0．019），A组水肿缓解率97．0％，B组为96．4％，多因素分析显示放射性支架植入与肿瘤客观有效率为患者预后好的独立性影响因素。结论TACE联合放射性支架植入对治疗肝细胞肝癌伴下腔静脉癌栓安全有效，可能延长患者生存时间。

英文摘要：

Objective To investigate the safety and efficacy of transarterial chemoembolization （TACE） combined with implantation of irradiation IVC stent in treating hepatocellular carcinoma （HCC） complicated by inferior vena cava tumor thrombosis （IVCTT）. Methods The clinical data of 61 consecutive patients with HCC complicated by IVCTT were retrospectively analyzed. Irradiation IVC stent was prepared by strapping ^125I particles on the bare stent, and it was employed in 33 patients （group A）. Bare stent was adopted in 28 patients （group B）. Propensity score matching method was used to conduct randomized analysis of the original data in order to reduce the selection bias. The survival time, remission rate of symptom and procedure-related adverse events of both groups were calculated and the results were compared between the two groups. Results The incidence of adverse reactions was similar in the two groups, and symptomatic treatment with internal medicine was adopted. The survival time in group A was superior to that in group B. The median survival time in group A was （203.0±28.1） days, which was （93.0±24.3） days in group B （P= 0.006）. Propensity score matching （24 pairs in total） cohort analysis showed that the median survival time was （200±31） days in group A and （66±23） days in group B （P=0.019）. The edema remission rates in group A and in group B were 97.0% and 96.4% respectively. Multiple factor analysis revealed that irradiation stent implantation and objective tumor response were independent factors predicting a good prognosis. Conclusion For the treatment of HCC associated with IVCTF, TACE combined with irradiation stent implantation is safe and effective, this therapy can prolong the patient＇s survival time.