超声引导下经皮微波消融联合无水酒精治疗原发性小肝癌患者的临床疗效  

Clinical effects of ultrasound-guided MWA combined with anhydrous alcohol in the treatment of patients with small primary hepatocellular carcinoma

作　　者：李占兰 刘国安 刘理冠 赖江琼 LI Zhan-lan;LIU Guo-an;LIU Li-guan;LAI Jiang-qiong(Ultrasound Diagnosis Department,Quanzhou Fujian,362000,China;不详)

机构地区：[1]泉州联勤保障部队第九一〇医院超声诊断科,福建泉州362000 [2]泉州联勤保障部队第九一〇医院感染科

出　　处：《中西医结合肝病杂志》2024年第9期818-820,825,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探究超声引导下经皮微波消融(MWA)联合无水酒精治疗原发性小肝癌患者的临床疗效。方法:纳入收治的284例原发性小肝癌患者作为研究对象,根据治疗方法的不同分为两组,其中对照组(n=181)患者采用超声引导下MWA治疗,观察组(n=103)患者采用超声引导下MWA联合无水酒精治疗,比较两组患者治疗后疗效、肝功能、并发症及预后情况。结果:观察组患者肿瘤完全消融率92.23%,高于对照组的72.38%(P<0.05)。两组患者治疗前ALT、AST及TBil水平比较差异无统计学意义(P>0.05);治疗后1周ALT、AST及TBil水平均较治疗前上升(P<0.05),两组患者治疗后比较差异无统计学意义(P>0.05);治疗1个月后ALT、AST及TBil水平与治疗前比较差异无统计学意义(P>0.05)。两组患者治疗期间发生的并发症包括肝区疼痛、肝周少量出血、胸腔积液以及发热,两组患者并发症发生率比较差异无统计学意义(P>0.05)。随访时间截至2023年12月,观察组肿瘤完全消融的95例患者中复发6例,复发率为6.32%,观察组无进展生存时间(PFS)为(13.55±4.03)个月;对照组肿瘤完全消融的131例患者中复发15例,复发率为11.45%,对照组PFS为(12.69±3.39)个月,两组患者治疗后复发率比较差异无统计学意义(χ^(2)=1.722,P=0.189),Kaplan-Meier生存分析结果显示两组PFS差异无统计学意义(χ^(2)=1.616,P=0.204)。结论:采用超声引导下经皮MWA联合无水酒精治疗原发性小肝癌患者可显著提升肿瘤完全消融率,且安全性高,可临床推广。Objective:The aim of this study was to explore the clinical effects of ultrasound-guided percutaneous microwave ablation(MWA)combined with anhydrous alcohol in the treatment of patients with small primary hepatocellular carcinoma.Methods:A retrospective study was conducted.A total of 284 patients with small primary hepatocellular carcinoma were admitted to the hospital between June 2020 and June 2023.They were selected as the study subjects and divided into the control group(n=181,ultrasound-guided MWA)and the observation group(n=103,ultrasound-guided MWA combined with anhydrous alcohol treatment)according to different treatment methods.Therapeutic effects,liver function,complications,and prognosis in the two groups were comparatively analyzed.Results:The complete ablation rate in the observation group(92.23%)was significantly higher than that in the control group(72.38%)(P<0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)in the two groups were comparable before treatment(P>0.05).One week after treatment,the levels of ALT,AST,and TBil in both groups increased(P<0.05),but there was no significant difference between the groups(P>0.05).One month after treatment,there was no significant difference in the levels of ALT,AST,and TBil compared to those before treatment(P>0.05).The incidence of complications in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).As of December 2023,6 of 95 patients in the observation group who obtained complete ablation experienced recurrence,with a recurrence rate of 6.32%.The progression free survival(PFS)of the observation group was(13.55±4.03)months.About 15 of 131 patients in the control group who obtained complete ablation experienced recurrence,with a recurrence rate of 11.45%.The PFS of the control group was(12.69±3.39)months.There was no statistically significant difference in recurrence rate between the two groups(χ^(2)=1.722,P=0.189).Kaplan-Meier s

关 键 词：原发性肝癌 微波消融 超声引导 无水酒精 疗效 

分 类 号：R735.7[医药卫生—肿瘤]