TACE联合MWA治疗原发性肝癌疗效分析  

Therapeutic effect of TACE combined with MWA on primary liver cancer

作　　者：张小玉 徐春阳 姚煜 戴峰[1] 臧志栋 ZHANG Xiao-yu;XU Chun-yang;YAO Yu;DAI Feng;ZANG Zhi-dong(Department of Hepatic Oncology,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine/Nanjing Second Hospital,Jiangsu 210003,China)

机构地区：[1]南京中医药大学附属南京医院/南京市第二医院肝脏肿瘤科,江苏210003

出　　处：《肝脏》2023年第11期1328-1330,共3页Chinese Hepatology

基　　金：南京市医学科技发展项目(K251)。

摘　　要：目的观察肝动脉化疗栓塞术(TACE)联合超声引导下微波消融术(MWA)治疗原发性肝癌疗效分析。方法收集南京中医药大学附属南京医院/南京市第二医院近2年单发性原发性肝癌96例,其中仅给予肝动脉栓塞化疗术的46例(对照组),在此基础上联合超声引导下微波消融术治疗的50例(治疗组),比较术后的血清总胆红素(TBil)、血清丙氨酸氨基转移酶(ALT)、血清天冬氨酸氨基转移酶(AST)、血清甲胎蛋白(AFP)等变化,以及1年内的肝癌复发情况。结果治疗组血清学指标AFP明显下降(t=34.06,P<0.05),1年内治疗组肝癌复发率18.00%,对照组1年内肝癌复发率89.13%(χ^(2)=48.56,P<0.05),两组血清TBil(t=0.065,P>0.05),ALT(t=0.079,P>0.05),AST(t=0.076,P>0.05)在保肝治疗下总体平稳,差异不大。结论肝动脉化疗栓塞术联合超声引导下微波消融术疗效远优于单纯肝动脉化疗栓塞术,对肝功能影响不大,但病例选择很重要,应尽量一次性彻底消融干净,否则有肝内外转移风险。Objective To observe the therapeutic effect of combining transcatheter arterial chemoembolization(TACE)with ultrasound-guided microwave ablation(MWA)in the treatment of primary liver cancer.Methods We collected data from 96 cases of single primary hepatocellular carcinoma in our hospital over the past two years.In the control group,46 cases were treated with transcatheter arterial chemoembolization.In the treatment group,50 cases were treated with transcatheter arterial chemoembolization and ultrasound-guided microwave ablation.We not only compared changes in serum total bilirubin(TBil),alanine aminotransferase(ALT),glutamic grass,transaminase(AST),serum alpha fetoprotein(AFP)before and after surgery,but also analyzed and recurrence of hepatocellular carcinoma within one year.Results The treatment group showed a significant decrease in serum AFP levels and a lower recurrence rate of hepatocellular carcinoma within one year(18.00%)compared to the control group(89.13%)(χ^(2)=48.56,P<0.05).The levels of serum TBil(t=0.065,P>0.05),ALT(t=0.079,P>0.05)and AST(t=0.076,P>0.05)were similar in both groups when undergoing hepatoprotective treatment.Conclusion The combined treatment of hepatic artery chemoembolization and ultrasound-guided microwave ablation yields significantly better curative results compared to simple hepatic artery chemoembolization,with little influence on liver function.However,patients selection plays a crucial role.It is recommended to perform thorough ablation at one time to minimize risk of intrahepatic and extrahepatic metastasis.

关 键 词：肝癌 微波消融术 肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]