目的：观察肝动脉灌注化疗栓塞（TACE）联合高强度聚焦超声（HIFU）治疗中晚期原发性肝癌的疗效及安全性。方法：76

例中晚期原发性肝癌患者，按随机数字表法分成治疗组36 例和对照组40 例。对照组患者单纯采用TACE治疗，治疗组患者于

TACE后2～3 周加用HIFU治疗。比较两组患者的临床疗效、手术前后甲胎蛋白（AFP）含量、生存率、生存期及不良反应。结果：

治疗组患者的显效率和总有效率分别为61.1％、94.4％，均显著高于对照组（35.0％、77.5％），差异有统计学意义（P＜0.05）。两组

患者治疗后的AFP含量均较治疗前显著下降，差异有统计学意义（P＜0.05），组间比较差异也有统计学意义（P＜0.05）。治疗组患

者在术后24、36 个月的生存率均高于对照组，差异有统计学意义（P＜0.05）。治疗组患者的中位生存期为11.3 个月，长于对照组的

9.2 个月，但组间比较差异无统计学意义（P＞0.05）。两组患者均未发生严重不良反应。结论：相较于单纯TACE，TACE联合HIFU

治疗中晚期原发性肝癌能提高患者远期生存率和近期疗效，且安全性较好。

OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization（TACE）combined

with high intensity focused ultrasound （HIFU） in the treatment of middle and advanced primary hepatocellular carcinoma

（HCC）. METHODS：76 patients with middle and advanced primary HCC were randomly divided into treatment group（36 cases）

and control group（40 cases）. Control group was given TACE alone，and treatment group was additionally given HIFU 2-3 weeks

after TACE. Clinical efficacy，the content of alpha-fetoprotein（AFP）before and after operation，survival rate，survival period and

ADR were compared between 2 groups. RESULTS：The efficiency rate and total effective rate of treatment group were 61.1％ and

94.4％，which were significantly higher than those of control group（35.0％，77.5％），with statistical significance（P＜0.05）. The

content of AFP in 2 groups decreased significantly after operation，with statistical significance（P＜0.05）；there also was statistical

significance between 2 groups（P＜0.05）. Survival rate of treatment group was higher than that of control group 24 and 36 months

after operation，with statistical significance （P＜0.05）. The median survival time was 11.3 months in treatment group and 9.2

month in control group，with no statistical difference（P＞0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS：Compared

with TACE alone，TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term

survival rate and the short-term efficacy，with good safety.