超声引导微波消融联合TACE治疗晚期原发性肝癌的疗效及对免疫功能的影响  

Curative Effect of Ultrasonic Guided Microwave Ablation Combined with TACE in the Treatment of Advanced Primary Liver Cancer and Its Influence on Immune Function

作　　者：杨立新 赵天慧 魏强 马芝倩 刘茜[1] 周晶晶 白淑芬 Yang Lixin;Zhao Tianhuil;Wei Qiang;Ma Zhiqian;Liu Qian;Zhou Jingjing;Bai Shufen(Department of Ultrasound,Nanjing Second Hospital,Nanjing Universily of Chinese Medicine,Nanjing,Jiangsu 210003,China;Department of gynaecology and obsteris,Nanjing Pukou Distriet Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu 211800,China)

机构地区：[1]南京中医药大学附属南京医院(南京市第二医院)超声科,南京市210003 [2]南京市浦口中医院妇产科

出　　处：《中国超声医学杂志》2020年第5期428-432,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨超声引导微波消融联合肝动脉化疗栓塞(TACE)在晚期原发性肝癌治疗中的应用效果,并分析其对机体免疫功能的影响。方法选取本院收治的晚期原发性肝癌患者,根据患者治疗方式的不同分为两组,通过倾向值匹配法匹配成功45对(每组45例)共90例,对照组行TACE治疗,联合组采用超声引导微波消融联合TACE治疗。对两组患者的近期疗效、并发症发生率、免疫功能变化等进行回顾性对比、分析。结果两组治疗后的CEA、AFP水平均较治疗前明显降低,CD4^+水平明显升高,并且联合组治疗后的CEA、AFP水平均显著低于对照组,CD4^+水平均显著高于对照组(P<0.05)。联合组的治疗总有效率显著高于对照组(88.89%vs 68.89%,P<0.05)。两组患者术后的恶心呕吐、发热、肝区疼痛发生率比较,差异均无统计学意义(P>0.05)。联合组患者术后1年的生存率为91.11%,显著高于对照组的66.67%(P<0.05)。结论超声引导微波消融联合TACE治疗晚期原发性肝癌能够有效控制肿瘤进展,提高近期疗效,同时还能增强患者的免疫功能,改善患者预后。Objective To explore the clinical effect of ultrasound-guided microwave ablation combined with TACE in the treatment of advanced primary liver cancer and its influence on the immune function of patients. Methods Patients with advanced primary liver cancer in our hospital were divided into two groups according to the different treatment methods. 45 pairs(45 cases in each group) were successfully matched by the tendency value matching method,90 cases in total. The control group received TACE, and the combined group received ultrasound-guided microwave ablation combined with TACE. The short-term curative effect, complication rate and immune function of the two groups were compared and analyzed. Results The levels of CEA and AFP in the two groups were significantly lower than those before treatment, and the levels of CD4^+ were significantly higher. Compared with control group, the levels of CEA and AFP in the combined group were significantly lower, and the levels of CD4^+ were significantly higher(P<0.05). The total effective rate in the combined group was significantly higher than control group(88.89% vs 68.89%, P<0.05). The incidence of nausea, vomiting, fever and pain in the liver area were compared between the two groups showed no significant difference(P>0.05). The 1-year survival rate of the combined group was significantly higher than control group(91.11% vs 66.67%, P<0.05). Conclusions Ultrasound-guided microwave ablation combined with TACE in the treatment of advanced primary liver cancer can effectively control the progress of tumor, improve the short-term efficacy. At the same time, it can enhance the immune function and improve the prognosis of patients.

关 键 词：免疫功能 原发性肝癌 肝动脉化疗栓塞 超声引导 微波消融 

分 类 号：R735.7[医药卫生—肿瘤]