超声造影辅助超声引导射频消融术治疗原发性肝癌疗效分析  

Efficacy Analysis of Contrast-enhanced Ultrasound Assisted Ultrasound-guided Radiofrequency Ablation in the Treatment of Primary Liver Cancer

作　　者：张瑶[1] 贾哲 何楠 王米雪 杨学平[1] 马晨瑶 张珂 Zhang Yao;Jia Zhe;He Nan;Wang Mixue;Yang Xueping;Ma Chenyao;Zhang Ke(Department of Ultrasound,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Universal Surgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015 [2]首都医科大学附属北京地坛医院普外科,北京市100015

出　　处：《中国超声医学杂志》2021年第8期892-896,共5页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学附属北京地坛医院院内科研基金“启航计划”项目(No.PTQH201810)。

摘　　要：目的探讨超声造影辅助经皮超声引导射频消融治疗原发性肝癌的临床应用价值。方法回顾性分析我院普外科接受超声引导下经皮射频消融术的194例原发性肝癌患者,共消融癌灶232个。将其中超声造影辅助超声引导肝癌射频消融术104例,癌灶128个,设为观察组;单纯超声引导肝癌射频消融术90例,癌灶104个,设为对照组。比较两组术后完全消融率、随访期总体生存率与无复发生存率、并发症发生情况以及影响术后总体生存率与无复发生存率的独立风险因素。结果观察组术后完全消融率以及随访期无复发生存率均高于对照组(P<0.05);两组术后并发症的发生情况以及随访期总体生存率差异无统计学意义(P>0.05);肿瘤大小为影响术后总体生存率及无复发生存率的独立危险因素[P=0.006,RR(95%CI):0.077~0.604],[P=0.028,RR(95%CI):0.020~0.1558]。结论超声造影辅助超声引导经皮射频消融术治疗原发性肝癌的疗效较好,可提高病灶的完全消融率及患者的无复发生存率,改善预后,提高患者生活质量,具有较高的临床应用价值。Objective To investigate the clinical value of contrast-enhanced ultrasound assisted percutaneous ultrasound-guided radiofrequency ablation in the treatment of primary liver cancer. Methods We retrospectively analyzed 194 patients with primary liver cancer who received ultrasound guided percutaneous radiofrequency ablation in the Department of General Surgery of our hospital. A total of 232 tumor foci were ablated. Among them, 104 patients with 128 cancer foci were observation group who underwent contrast-enhanced ultrasound assisted ultrasound-guided radiofrequency ablation. Ultrasound-guided radiofrequency ablation was performed in 90 patients with 104 cancer foci, which were set as control group. The total ablation rate, overall survival rate and relapse-free survival rate during the follow-up period, the incidence of complications, and the independent risk factors affecting overall survival rate and relapse-free survival rate were compared between the two groups. Results The total ablation rate and relapse-free survival rate in observation group were higher than those in control group(P<0.05). There were no significant difference in the incidence of postoperative complications and overall survival rate during follow-up between the two groups(P>0.05). Tumor size classification was an independent risk factor affecting postoperative overall survival and relapsed-free survival [P=0.006, RR(95%CI): 0.077~0.604], [P=0.028, RR(95%CI): 0.020~0.1558]. Conclusions Contrast-enhanced ultrasound assisted ultrasound-guided percutaneous radiofrequency ablation is better in treatment of primary liver cancer. It can improve the complete ablation rate of lesions and the relapse-free survival rate of patients, improve the prognosis and the quality of life, which has high clinical application value.

关 键 词：肝癌 射频消融 超声造影 无复发生存率 完全消融率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]