超声引导下射频消融治疗小原发性肝癌的效果及死亡危险因素  

Efficacy and Risk Factors of Death of Ultrasound-Guided Radiofrequency Ablation for Small Primary Hepatic Cancer

作　　者：王焕文 林冠华 陈馨馨 WANG Huanwen;LIN Guanhua;CHEN Xinxin(Department of Ultrasound,Quanzhou Guangqian Hospital,Quanzhou 362321,China)

机构地区：[1]泉州市光前医院超声科,福建泉州362321

出　　处：《临床医学工程》2025年第4期443-446,共4页Clinical Medicine & Engineering

摘　　要：目的分析小原发性肝癌(PHC)经超声引导下射频消融(FRA)治疗的效果,同时分析患者死亡的危险因素。方法选取2020年3月至2024年1月收治的小PHC患者100例,均采取超声引导下FRA治疗。在治疗后的1个月对治疗效果进行评估,同时进行为期2年的随访工作。通过单因素、多因素Logistic分析影响患者死亡的因素。结果100例患者近期总有效率73.00%;1年随访生存率90.00%,2年随访生存率77.00%。生存、死亡患者的年龄、性别、ALB、肝炎、ALT和AST无统计差异(P>0.05);然而死亡患者的血清AFP、病灶临近血管比例、Child Pugh C级占比、肿瘤细胞分化、未接受抗病毒治疗占比均高于生存患者(P<0.05);多因素Logistic回归分析显示,小PHC患者死亡以病灶临近血管、血清AFP、未接受抗病毒治疗、Child Pugh C级为独立危险因素(P<0.05)。结论超声引导下RFA治疗小PHC具有良好的近期疗效,掌握对患者长时间生存产生影响的因素且进行积极的处理可能延长患者的生存时间。Objective To analyze the efficacy of ultrasound-guided radiofrequency ablation(FRA)in the treatment of small primary hepatic cancer(PHC),and to analyze the risk factors of death.Methods 100 patients with small PHC from March 2020 to January 2024were selected and treated with ultrasound-guided FRA.The therapeutic effect was evaluated 1 month after treatment,and a 2-year follow-up was conducted.Univariate and multivariate Logistic analysis were used to analyze the factors affecting the death of patients.Results The recent total effective rate of 100 patients was 73.00%;the 1-year follow-up survival rate was 90.00%,and the 2-year follow-up survival rate was 77.00%.No statistical difference showed in age,gender,ALB,hepatitis,ALT and AST between survival and death patients(P>0.05).However,the serum AFP,the proportion of blood vessels adjacent to the lesion,the proportion of Child Pugh grade C,tumor cell differentiation,and the proportion of patients who did not receive antiviral treatment in dead patients were higher than those in survival patients(P<0.05);multivariate Logistic regression analysis showed that the independent risk factors of death in patients with small PHC were blood vessels adjacent to the lesion,serum AFP,no antiviral treatment,and Child Pugh C(P<0.05).Conclusions Ultrasound-guided RFA therapy for small PHC has good short-term efficacy.Mastering the factors that affect the long-term survival of patients and taking active treatment may prolong the survival time of patients.

关 键 词：小原发性肝癌 超声引导 死亡危险因素 射频消融 

分 类 号：R735.7[医药卫生—肿瘤]