射频和微波消融治疗肝癌并发症分析

Complications of thermal ablation of liver cancer： comparison of radiofrequency and microwave techniques

【摘要】目的分析热消融治疗肝癌并发症的原因及防治措施，并比较射频消融（RFA）和微波消融（MwA）两种消融技术的安全性。方法对879例肝癌患者实施热消融治疗，RFA组323例，MWA组556例，比较两种消融技术治疗肝癌的并发症。结果879例患者1_652个肿瘤共接受1030次热消融治疗。323例562个肿瘤接受376次RFA；556例1090个肿瘤接受654次MwA。RFA组和MwA组死亡、严重并发症、轻微并发症发生率分别为0．31％（1／323）、3．5％（13／376）、5．90o（22／376）和0．36％（2／556）、3．1％（20／654）、5．7％（37／654）。两组比较差异无统计学意义（P〉0．05）。结论热消融治疗肝癌是安全的，死亡和严重并发症发生率较低，而且MWA与RFA具有相同的安全性。

Objective To investigate the common complications of thermal ablations of liver cancer using both radiofrequency ablation （RFA） and microwave ablation （MWA） techniques, and compare the safety between these two procedures. Methods A total of 879 patients with hepatic tumors underwent thermal ablation. There were 323 cases having the RFA procedures and 556 cases having MWA procedures. The complications of thermal ablations of liver cancer were compared using both RFA and MWA techniques. Results A total of 1030 thermal ablation sessions was performed in 879 patients with a total of 1652 tumors. There were 323 patients with 562 tumors received a total of 376 RFA. The other 556 patients with 1090 tumors received a total of 654 MWA. The mortality rates were 0.31% （1/323） and 0.36% （2/ 556） in RFA and MWA group. In RFA and MWA group,the major complication rates were 3.5%（13/376） and 3. 1% （20/654） ,meanwhile the minor complication rates were 5.9%（22/376） and 5.7% （37/654）. There was no statistical significant difference for the mortality rates, the major complications, the minor complications between the RFA and MWA groups （ P 〉0. 05）. Conclusions Thermal ablation therapy in the treatment of liver cancers is relatively safe with low mortality and low incidence of serious complications. The types and incidences of complications caused by RFA and MWA are similar and comparable for safety consideration in clinical settings.