微波消融联合肝动脉栓塞术治疗结直肠癌术后肝转移的疗效及对肝功能变化的影响  

Microwave ablation combined with hepatic artery embolization for treatment of liver metastasis after surgery for colorectal cancer:Efficacy and effect on liver function

作　　者：刘雪平[1] 周余旺[1] 刘庆华[1] 姜露露 Xue-Ping Liu;Yu-Wang Zhou;Qing-Hua Liu;Lou-Lou Jiang(Department of ultrasound, Quzhou People＇s Hospital, Quzhou 324000, Zhejiang Province, Chin)

机构地区：[1]浙江省衢州市人民医院超声科,浙江省衢州市324000

出　　处：《世界华人消化杂志》2018年第10期587-593,共7页World Chinese Journal of Digestology

摘　　要：目的对比分析单独肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗与TACE联合微波消融术(microwave ablation,MWA)治疗结直肠癌肝转移患者的疗效及预后影响.方法收集2013-01/2015-01在我院治疗的84例原发性结直肠癌患者的临床资料进行回顾性分析,患者依据不同治疗方案分为TACE联合MWA组(n=40)、单独TACE组(n=44).比较两组患者的治疗效果及不良反应发生情况,比较两组患者的肝功能变化、生活质量及生存情况.结果治疗后1 mo,TACE联合MWA组和单独TACE组的治疗有效率、疾病控制率分别为77.5%、85.0%和38.6%、56.8%;TACE联合MWA组的治疗有效率、疾病控制率均显著高于单独TACE组(χ~2=5.441,P<0.05).治疗1周后,两组患者的血清总胆红素、A LT及白蛋白水平比较均无显著差异(t=3.662,2.816,2.578,P>0.05).治疗期间,两组患者恶心、呕吐、血小板减少、白细胞减少、血红蛋白减少、黏膜炎、胆碱能综合征及迟发性腹泻等不良反应发生情况比较均无显著差异(χ~2=1.056,0.784,1.022,2.103,0.668,P>0.05).治疗6 mo后,TACE联合MWA组患者的生理状况、情感状况、功能状况、家庭及社会状况、生活质量总评分均显著高于单独TACE组患者(t=5.139,6.052,4.331,4.508,4.417,P<0.05).TA C E联合M WA组患者治疗后半年、1年的生存率与单独TACE组患者比较无显著差异(χ~2=0.216,1.492,P>0.05),但治疗后2年、3年的生存率均显著高于单独TACE组患者(χ~2=3.894,4.017,P<0.05).结论微波消融联合肝动脉栓塞术治疗结直肠癌肝转移患者疗效显著,且相比于单独的肝动脉化疗栓塞术能够进一步提高患者的生活质量、延长生存时间,同时不会增加不良反应发生情况.AIM To compare the therapeutic effects and prognosis in patients with liver metastasis of colorectal cancer treated by transcatheter arterial chemoembolization （TACE） alone and those treated by TACE combined with microwave ablation （MWA）. METHODS The clinical data of 84 patients with primary colorectal cancer treated at our hospital from January 2013 to January 2015 were retrospectively analyzed. The patients were divided into either a combination group （TACE combined with MWA; n = 40） or a TACE alone group （n = 44） according to different treatment plans. The therapeutic effect and adverse reactions were compared between the two groups, and the changes of liver function, quality of life, and survival were also compared. RESLIL TS At one month after treatment, the effective rate and disease control rate were significantly higher in the combination group than in the TACE alone group （77.5% vs 38.6%, 85.0% vs 56.8%, P 〈 0.05）. After I wk of treatment, there was no significant difference in serum total bilirubin, ALT, or albumin levels in the two groups （t = 3.662, 2.816, 2.578, P 〉 0.05）. During the treatment period, there was no significant difference in the incidence of nausea, vomiting, thrombocytopenia, leukocyte reduction, hemoglobin reduction, mucositis, cholinergic syndrome, or delayed diarrhea between the two groups （x2 = 1.056, 0.784, 1.022, 2.103, 0.668, P 〉 0.05）. After 6 mo of treatment, the physiological status, emotional status, functional status, family and social status, and quality of life scores were significantly higher in the combination group than in the TACE alone group （t = 5.139, 6.052, 4.331, 4.508, 4.417, P 〈 0.05）. There was no significant difference in the survival rates at six months and 1 year （x2 = 0.216, 1.492, P 〉 0.05）, but the 2- and 3- year survival rates were significantly higher than those in the TACE alone group （x2 = 3.894, 4.017, P 〈 0.05）. CONCLUSION Microwave ablation combined with TACE is effective in the treatment of liv

关 键 词：微波消融术 肝动脉栓塞术 结直肠癌 肝转移 

分 类 号：R735.34[医药卫生—肿瘤] R735.7[医药卫生—临床医学]