肝动脉化疗栓塞术联合微波消融治疗早期肝癌的效果及其影响因素  

Efficacy and influencing factors of transarterial chemoembolization combined with microwave ablation in the treatment of early liver cancer

作　　者：黄凯[1] 霍传红[1] 解景东 郭欣 Huang Kai;Huo Chuanhong;Xie Jingdong;Guo Xin(Department of Infectious Diseases,Dezhou People’s Hospital,Dezhou 253000,China)

机构地区：[1]山东省德州市人民医院感染科,253000

出　　处：《中国实用医刊》2020年第9期69-72,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析肝动脉化疗栓塞术(TACE)联合微波消融治疗早期肝癌的效果及其影响因素。方法选取2018年1月至2019年1月德州市人民医院收治的早期肝癌患者58例,采用随机数字表法将其分成常规治疗组与联合治疗组,每组29例,分别接受微波消融术治疗及微波消融术联合TACE术治疗。比较两组患者的临床疗效、复发情况及并发症发生情况,分析联合治疗患者早期复发的危险因素。结果联合治疗组(93.10%,27/29)临床疗效优于常规治疗组(72.41%,21/29),P<0.05;联合治疗组复发率(3.45%,1/29)低于常规治疗组(17.24%,5/29),P<0.05;联合治疗组并发症发生率(34.48%,10/29)高于常规治疗组(31.03%,9/29),但差异未见统计学意义(P>0.05)。甲胎蛋白(AFP)≥100μg/L、病毒数量≥103拷贝/ml、肿瘤边缘不规整与早期肝癌TACE联合微波消融治疗后复发相关(P<0.05),Child-Pugh分级、肿瘤数目、肿瘤长径与早期肝癌TACE联合微波消融治疗后复发无关(P>0.05)。AFP≥100μg/L、病毒数量≥103拷贝/ml、肿瘤边缘不规整是影响早期肝癌TACE联合微波消融治疗后复发的危险因素(P<0.05)。结论TACE术联合微波消融术治疗早期肝癌能明显提升其治疗效果,减少复发,而术前控制复发危险因素有利于临床治疗。Objective To investigate the efficacy and influencing factors of transarterial chemoembolization(TACE)combined with microwave ablation on early liver cancer.Methods Fifty-eight patients with early liver cancer admitted to Dezhou People’s Hospital from January 2018 to January 2019 were selected,and they were divided into conventional therapy group and combined therapy group by random number table method,with 29 cases in each group.Patients in the conventional therapy group were treated by microwave ablation,while patients in the combined therapy group were treated by TACE combined with microwave ablation.The clinical efficacy,recurrence and complications of the two groups were compared,and the risk factors of early recurrence were analyzed.Results The clinical effect of the combined therapy group(93.10%,27/29)was better than that of the conventional therapy group(72.41%,21/29),P<0.05.The recurrence rate of the combined therapy group(3.45%,1/29)was lower than that of the conventional therapy group(17.24%,5/29),P<0.05.The complication rate of the combined therapy group(34.48%,10/29)was higher than that of the conventional therapy group(31.03%,9/29),but the difference was not statistically significant(P>0.05).Recurrence after TACE combined with microwave ablation for early liver cancer was correlated with alpha-fetoprotein(AFP)≥100μg/L,number of virus≥103 copies/ml,and irregular tumor margins(P<0.05),and was not correlated with child-pugh grade,number of tumors,and major diameter of tumor(P>0.05).AFP≥100μg/L,number of virus≥103 copies/ml and irregular tumor margins were risk factors of recurrence after TACE combined with microwave ablation for early liver cancer(P<0.05).Conclusions TACE combined with microwave ablation in the treatment of early liver cancer can significantly improve its therapeutic effect and reduce recurrence,while the preoperative control of recurrence risk factors is of great clinical value.

关 键 词：肝癌 肝动脉化疗栓塞术 微波消融术 疗效 因素 

分 类 号：R735.7[医药卫生—肿瘤]