3D超声融合成像导航技术联合实时超声造影在原发性小肝癌微波消融术中的应用研究  

Application of 3D ultrasound fusion imaging navigation technology combined with real-time contrast ultrasound in microwave ablation of primary small liver cancer

作　　者：周怀明 董鑫鑫 邹璐璐 ZHOU Huai-ming;DONG Xin-xin;ZOU Lu-lu(Department of Ultrasound Medicine,Harbin Second Hospital,Harbin Heilongjiang 150000,China)

机构地区：[1]哈尔滨市第二医院超声科,黑龙江哈尔滨150000

出　　处：《临床和实验医学杂志》2024年第9期991-995,共5页Journal of Clinical and Experimental Medicine

基　　金：黑龙江省卫生健康委科研课题项目(编号:2017-210)。

摘　　要：目的探讨3D超声融合成像导航系统(3DUIFNS)联合实时超声造影(CUES)在原发性小肝癌微波消融术中的应用价值,进一步明确预后独立影响因素,分析不同指导技术对预后的影响。方法前瞻性选取2020年2月至2021年2月哈尔滨市第二医院收治的原发性小肝癌患者104例作为研究对象,均择期行微波消融术。按照随机抽签法将患者分成CUES组、3DUIFNS+CEUS组,每组各52例。比较两组一次完全消融率、补充消融率及并发症情况。术后随访2年,记录2年无瘤生存与累积生存情况,经Kaplan-Meier法与Log-Rank检验进行生存分析,并采用Cox回归模型分析预后独立影响因素。结果3DUIFNS+CEUS组一次完全消融率为88.46%,高于CUES组(71.15%),补充消融率为11.54%,低于CUES组(28.85%),差异有统计学意义(P<0.05)。两组腹腔积液、胸腔积液、腹腔出血、血气胸、肝功能损害、肝区疼痛发生率比较,差异均无统计学意义(P>0.05)。3DUIFNS+CEUS组平均无瘤生存期22个月,无瘤生存率92.00%;CUES组平均无瘤生存期20个月,无瘤生存率76.47%。3DUIFNS+CEUS组无瘤生存期长于CUES组,差异有统计学意义(P<0.05)。3DUIFNS+CEUS组平均总生存期23个月,总生存率94.00%;CUES组平均总生存期22个月,总生存率80.39%。3DUIFNS+CEUS组平均总生存期长于CUES组,差异有统计学意义(P<0.05)。Cox回归分析提示,分化程度、肿瘤转移、大血管受累、肿瘤包膜、消融效果、手术指导方式是原发性小肝癌患者无瘤生存期、总生存期的独立影响因素(P<0.05)。结论3DUIFNS+CEUS能提高原发性小肝癌患者微波消融术的一次完全消融率,且会影响远期预后,可提升无瘤生存率、总生存率,此外,患者远期预后还受肿瘤分化程度、肿瘤转移、大血管受累、肿瘤包膜、消融效果的影响,临床需引起重视。Objective To investigate the application value of 3D ultrasound fusion imaging navigation system(3DUIFNS)combined with real-time contrast ultrasonography(CUES)in microwave ablation of primary small liver cancer,further identify the independent influencing factors of prognosis,and analyze the influence of different guidance techniques on prognosis.Methods A total of 104 patients with primary small liver cancer admitted to Harbin Second Hospital from February 2020 to February 2021 were prospectively enrolled,and all of them were selected to receive MWA.Patients were divided into the CUES group and the 3DUIFNS+CEUS group according to the random drawing method,with 52 cases in each group.The rate of primary complete ablation,supplementary ablation and complications were compared between the two groups.After 2 years of postoperative follow-up,2-year tumor free survival and cumulative survival were recorded.Kaplan-Meier method and Log-Rank test were used for survival analysis,and Cox regression model was used to analyze independent prognostic factors.Results The primary complete ablation rate of the 3DUIFNS+CEUS group was 88.46%,which was higher than that of the CUES group(71.15%),and the supplementary ablation rate was 11.54%,which was lower than that of the CUES group(28.85%),the difference was statistically significant(P<0.05).There were no statistically significant differences in the incidence of abdominal effusion,pleural effusion,abdominal hemorrhage,hemopneumthorax,liver function injury and hepatic pain between the two groups(P>0.05).The average tumor-free survival of the 3DUIFNS+CEUS group was 22 months,and the average tumor-free survival rate was 92.00%,while the average tumor-free survival rate of the CUES group was 20 months,and the tumor free survival rate was 76.47%.The average tumor-free survival of the 3DUIFNS+CEUS group was longer than that of the CUES group,and the difference was statistically significant(P<0.05).The average overall survival of the 3DUIFNS+CEUS group was 23 months,and the overall survi

关 键 词：原发性小肝癌 微波消融术 3D超声融合成像导航 超声造影 

分 类 号：R735.7[医药卫生—肿瘤]