中国普外基础与临床杂志

中国普外基础与临床杂志

中晚期原发性肝癌肝动脉化疗栓塞术后常规超声与超声造影引导下射频消融的疗效比较

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目的 探讨超声造影引导下射频消融治疗 TACE 术后中晚期原发性肝癌的疗效。 方法 前瞻性收集 2014 年 1–12 月期间在柳州市工人医院住院且首次治疗方式采用 TACE 治疗的中晚期原发性肝癌患者,采用随机数字表法随机分入常规超声引导下射频消融组(对照组)与超声造影引导下射频消融组(研究组),观察 2 组患者术后完全消融率、肝功能、血清甲胎蛋白(AFP)水平以及 1、2、3 年生存率。 结果 本研究共收集到符合入组条件的经 TACE 治疗的中晚期原发性肝癌患者 42 例,每组 21 例。① 2 组患者术前基线资料如性别、年龄、BCLC 分期、AFP 及肝功能 Child 分级比较差异均无统计学意义(P>0.05)。② 2 组患者均按计划完成相应治疗,未发生严重并发症,无与治疗相关死亡病例。射频消融后 1 个月复查时研究组的完全消融率明显高于对照组(χ2=5.717,P=0.017),AFP 水平显著低于对照组(t=2.618,P=0.012),2 组间肝功能 Child 分级比较差异无统计学意义(P>0.05)。③ 研究组再次行射频消融治疗率明显低于对照组(χ2=4.434,P=0.035),2 组再次行 TACE 治疗率比较差异无统计学意义(χ2=1.659,P=0.197)。④ 2 组生存曲线比较,研究组的生存情况明显优于对照组(χ2=3.999,P=0.046)。 结论 中晚期原发性肝癌 TACE 术后超声造影引导下射频消融的治疗效果优于常规超声引导。

Objective To explore therapeutic effect of radiofrequency ablation (RFA) guided by contrast-enhanced ultrasound in patient with advanced primary liver cancer following transcatheter arterial chemoembolization (TACE). Methods The patients with advanced primary liver cancer treated with the TACE firstly from January to December 2014 in this hospital were prospectively collected, then were randomly divided into a conventional ultrasound guided RFA group (control group) and contrast-enhanced ultrasound guided RFA group (study group). The complete ablation rate, liver function, serum alpha-fetoprotein (AFP) level, and 1-, 2-, and 3-year survival rates were observed in the two groups. Results A total of 42 patients with advanced primary liver cancer treated with the TACE were enrolled in this study, there were 21 patients in each group. ① There were no significant differences in the baseline data such as the gender, age, BCLC stage, AFP level, and Child grade of liver function between the two groups (P>0.05). ② All the treatments were completed according to the plan, no serious complications or treatment-related death happened. The complete ablation rate of the study group was significantly higher than that of the control group (χ2=5.717, P=0.017), and the AFP level was significantly lower than that of the control group (t=2.618, P=0.012). There was no significant difference in the Child grade of liver function between the 2 groups (P>0.05). ③ The rate of repeat RFA in the study group was significantly lower than that in the control group (χ2=4.434, P=0.035), and there was no significant difference in the TACE treatment rate between the two groups (χ2=1.659, P=0.197). ④ The survival rate of the study group was significantly better than that of the control group by comparing the survival curves (χ2=3.999, P=0.046). Conclusion Contrast-enhanced ultrasound guided RFA is superior to conventional ultrasound guided RFA in treatment of advanced primary liver cancer following TACE.

关键词: 原发性肝癌; 射频消融; 肝动脉化疗栓塞; 超声造影

Key words: primary liver cancer; radiofrequency ablation; transcatheter arterial chemoembolization; contrast-enhanced ultrasound

引用本文: 卢思聪, 任启洪, 黄晴, 卢海明. 中晚期原发性肝癌肝动脉化疗栓塞术后常规超声与超声造影引导下射频消融的疗效比较. 中国普外基础与临床杂志, 2018, 25(11): 1318-1322. doi: 10.7507/1007-9424.201806009 复制

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