本文關(guān)鍵詞： 癌 肝細(xì)胞 超聲檢查 導(dǎo)管消融術(shù) 微波　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2015年08期 　論文類型：期刊論文

【摘要】：目的探討超聲引導(dǎo)下經(jīng)皮射頻消融與微波消融治療原發(fā)性肝癌的臨床療效。資料與方法選擇超聲引導(dǎo)下消融治療的92例(116個(gè)病灶)原發(fā)性肝細(xì)胞癌患者,隨機(jī)分為射頻消融組(46例)和微波消融組(46例),分別給予射頻消融和微波消融治療,比較兩組患者消融術(shù)中消融點(diǎn)數(shù)、消融時(shí)間、完全消融率、局部腫瘤進(jìn)展率、術(shù)后并發(fā)癥、術(shù)后住院時(shí)間、住院費(fèi)用以及術(shù)后1年、2年、3年復(fù)發(fā)率及無復(fù)發(fā)生存率。結(jié)果兩組術(shù)中平均消融點(diǎn)數(shù)差異無統(tǒng)計(jì)學(xué)意義(P0.05),微波消融組術(shù)中消融時(shí)間明顯短于射頻消融組(P0.01)。兩組腫瘤完全消融率和局部腫瘤進(jìn)展率差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組腫瘤直徑3 cm者、腫瘤直徑3~5 cm者、近血管腫瘤的完全消融率和局部腫瘤進(jìn)展率比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組術(shù)后發(fā)熱發(fā)生率、肝區(qū)疼痛發(fā)生率及平均住院時(shí)間比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。微波消融組平均住院費(fèi)用明顯低于射頻消融組(P0.01)。兩組術(shù)后1年、2年、3年累計(jì)復(fù)發(fā)率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組總體無復(fù)發(fā)生存率以及不同大小腫瘤無復(fù)發(fā)生存率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論微波消融治療原發(fā)性肝細(xì)胞癌的臨床療效及安全性與射頻消融相當(dāng)。射頻消融治療對較小的腫瘤有更好的治療效果,微波消融治療對中等或較大的腫瘤及近血管腫瘤具有一定的優(yōu)勢。
[Abstract]:Objective to evaluate the clinical efficacy of ultrasound guided percutaneous radiofrequency ablation (RFA) and microwave ablation in the treatment of primary hepatocellular carcinoma (HCC). The patients were randomly divided into radiofrequency ablation group (n = 46) and microwave ablation group (n = 46). The number of ablation points, ablation time, complete ablation rate, local tumor progression rate and postoperative complications were compared between the two groups. Postoperative hospital stay, Results there was no significant difference in mean ablation points between the two groups (P 0.05). The ablation time in microwave ablation group was significantly shorter than that in radiofrequency ablation group (P 0.01). There was no significant difference in total ablation rate and local tumor progression rate between the two groups (P 0.05). The diameter of the tumor was 3 cm in the two groups. There was no significant difference in the complete ablation rate and the local tumor progression rate between the two groups with a diameter of 3 ~ 5 cm. The incidence of postoperative fever, liver pain and average length of stay were compared between the two groups. The average hospitalization cost of microwave ablation group was significantly lower than that of radiofrequency ablation group (P 0.01). The cumulative recurrence rate was 1 year, 2 years and 3 years after operation in both groups. There was no significant difference between the two groups (P 0.05). The overall recurrence free survival rate and the recurrence free survival rate of different size tumors were compared between the two groups. Conclusion the clinical efficacy and safety of microwave ablation for primary hepatocellular carcinoma is similar to that of radiofrequency ablation. Microwave ablation has some advantages over medium or larger tumors and proximal vascular tumors.
【作者單位】： 青島市中心醫(yī)院腫瘤介入科;青島市市立醫(yī)院超聲科;
【分類號】：R445.1;R735.7

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