微波消融联合肝动脉化疗栓塞治疗小肝癌  

The effect of PMCT combined TACE on the treatment of small liver carcinoma

作　　者：李新慧[1] 冯志强[2] 张洪义[2] 吴迪[3] 刘洋[2] 汪鑫[2] 邹玉峰[2] 赵二鹏[2] 

机构地区：[1]安徽医科大学空军临床学院,安徽合肥230023 [2]中国人民解放军空军总医院肝胆外科,北京100142 [3]中国人民解放军空军总医院超声科,北京100142

出　　处：《中国医刊》2016年第1期64-67,共4页Chinese Journal of Medicine

基　　金：首都卫生发展科研专项(2011-2041-02);"十二五"全军后勤科研计划项目(BWS12J029)

摘　　要：目的评价肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合超声引导下经皮微波消融(percutaneous microwave coagulation therapy,PMCT)治疗初发小肝癌的临床效果及其必要性。方法回顾性分析2011年1月至2013年10月解放军空军总医院肝胆外科小肝癌患者行PMCT治疗54例,根据消融术前是否行TACE将54例患者分为两组:单纯PMCT组23例,PMCT联合TACE治疗组31例,比较两组患者治疗后肝功能变化情况、平均住院时间、总体生存率、肿瘤局部进展率、肝内远处复发率、无瘤生存率。结果单纯PMCT组与TACE联合PMCT组治疗后1天转氨酶指标均较术前增高,胆色素指标较术前无明显变化,组间比较治疗前两组肝功指标无差异,治疗后1天转氨酶指标有差异,胆色素指标无明显差异。联合治疗组的住院时间[(16.2±8.1)天]比单纯治疗组长[(9.9±4.5)天],差异有显著性(P<0.05)。单纯治疗组与联合治疗组总体生存率差异无显著性(P>0.05)。联合治疗组的局部进展率、肝内远处复发率低于单纯治疗组,无瘤生存率高于单纯治疗组,差异均有显著性(P<0.05)。结论对于小肝癌的治疗有必要PMCT术前行TACE`联合治疗在近期内可减少小肝癌局部进展及肝内远处复发的机会,提高无瘤生存率,但肝功能损害稍重,住院时间较长,不能增加近期生存率。Objective To analyze the effectiveness and necessity of percutaneous microwave coagulation therapy （PMCT） combined with transcatheter arterial chemoembolization （TACE） for the treatment of small liver carcinoma. Method The clinical data of 54 small liver carcinoma patients who had received PMCT （group A, 23 cases） alone or in combination with TACE （group B, 31 cases） were retrospectively analyzed. Result The value of AST and ALT value 1 day after therapy have significant different compared to those before the surgery, group B is worse than group A, but there is no significant different with bilirubin levels. The rate of intrahepatic distant recurrence and local tumor progression in group B was lower than that in group A and the tumor-free survival rate was higher than group A. There were no differences in overall survival between two groups. The hospital stay was longer in group B than group A. Conclusion It is essential to combined PMCT with TACE for therapy of small liver carcinoma. Combine therapy is able to reduce short-term recurrence, and improve tumor-free survival. But liver damage heavier, the length of hospital stay longer, don＇t add the recent survival rate.

关 键 词：肝癌 微波消融 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤]