老年肝癌患者射频消融术后病灶残留的影响因素分析  

Residual lesions after radiofrequency ablation in elderly patients with liver cancer:An analysis of influencing factors

作　　者：周轼瑜[1] 张国雷[1] 慎华平[1] 严强[1] Zhou Shiyu;Zhang Guolei;Shen Huaping;Yan Qiang(Department of General Surgery,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院普通外科,湖州313000

出　　处：《中华老年医学杂志》2019年第11期1254-1257,共4页Chinese Journal of Geriatrics

摘　　要：目的分析老年肝癌患者射频消融术后病灶残留的影响因素。方法以2014年1月至2016年12月在我院进行射频消融术治疗的65例老年肝癌患者为研究对象,对其临床资料进行回顾性分析,采用单因素分析和多因素Logistic回归分析射频消融术后病灶残留的影响因素。结果65例老年肝癌患者的102个病灶首次完全消融87个,首次病灶完全消融率为85.3%(87/102),56例患者的病灶首次完全消融,首次病例完全消融率为86.2%(56/65),9例患者的15个病灶为不完全消融。单因素分析结果显示,性别(χ^2=0.740,P=0.390)、是否合并肝硬化(χ^2=0.745,P=0.388)、是否合并乙型肝炎(χ^2=0.057,P=0.812)及肝癌类型(χ^2=0.171,P=0.680)对射频消融术后病灶残留的影响无统计学意义,而病灶数目(χ^2=6.694,P=0.010)、病灶大小(χ^2=14.382,P=0.000)及肝功能分级(χ^2=5.359,P=0.030)对射频消融术后病灶残留的影响有统计学意义;进一步行多因素Logistic回归分析结果显示,病灶数目≥3个(OR=1.916,95%CI:1.326~2.571,P=0.029)、病灶大小≥3 cm(OR=2.362,95%CI:2.180~2.923,P=0.000)是射频消融术后病灶残留的危险因素。结论射频消融术对老年肝癌患者总体治疗效果较好,病灶数目和病灶大小对射频消融术后病灶残留有一定程度的影响。Objective To analyze the influencing factors for residual lesions after radiofrequency ablation in elderly patients with liver cancer.Methods Clinical data of 65 elderly patients with liver cancer treated by radiofrequency ablation in our hospital from January 2014 to December 2016 were retrospectively analyzed.The influencing factors on residual lesions after radiofrequency ablation were analyzed by univariate analysis and multivariate logistic regression.Results Of 102 lesions in 65 elderly patients with liver cancer,87 lesions were completely ablated at the first time,and the first complete ablation rate of lesion was 85.29%(87/102).All visible lesions were completely ablated in 56 patients at the first time,and the first complete ablation rate of cases was 86.15%(56/65).Fifteen lesions in 9 patients were incompletely ablated.Univariate analysis showed that gender(χ^2=0.740,P=0.390),cirrhosis(χ^2=0.745,P=0.388),hepatitis B(χ^2=0.057,P=0.812)and type of liver cancer(χ^2=0.171,P=0.682)had no significant effect on the residual lesions after radiofrequency ablation,but the number of lesions(χ^2=6.694,P=0.010),the lesion size(χ^2=14.382,P=0.000)and liver function classification(χ^2=5.359,P=0.030)had statistically significant effects on residual lesions after radiofrequency ablation.Further multivariate logistic regression analysis showed that the number of lesions≥3(OR=1.916,95%CI:1.326~2.571,P=0.029),the size of lesions≥3 cm(OR=2.362,95%CI:2.180~2.923,P=0.000)were risk factors for residual lesions after radiofrequency ablation.Conclusions Radiofrequency ablation has a better therapeutic effect on liver cancer in elderly patients.The number and size of lesions have a certain impact on the residual lesions after radiofrequency ablation.

关 键 词：肝肿瘤 导管消融术 治疗效果 

分 类 号：R73[医药卫生—肿瘤]