超声造影对肝动脉栓塞化疗与高强度聚焦超声联合治疗原发性肝癌的临床疗效评价

Value of contrast-enhanced ultrasonography in evaluating curative effect of TACE combined with HIFU for treating hepatocellular carcinoma

目的探讨超声造影对动脉栓塞化疗（TACE）与高强度聚焦超声（HIFU）联合治疗原发性肝癌的临床疗效评价。方法经TACE与HIFU联合治疗原发性肝癌（联合组）患者22例，经单纯TACE组54例，单纯HIFU治疗组41例。经TACE与HIFU联合治疗前及治疗后1周进行超声造影检查，观察肿瘤组织内部有无残留血供和遗漏病灶，并对经TACE治疗1～3次未完全灭活的病灶行HIFU补充治疗。结果TACE组和HIFU组肿瘤灭活率均低于联合组，肿瘤残存率均高于联合组（P〈0．05）；联合组6个月、1年、2年生存率分别为100％、90．9％、81．8％，高于TACE组和HIFU组（P〈0．05）。结论超声造影对TACE与HIFU联合治疗原发性肝癌的临床疗效能够做出准确判断，显示经TACE与HIFU联合治疗肝癌的疗效明显优于单纯TACE或HIFU治疗。

ABSTRACT Objective To explore the value of contrast-enhanced uhrasonography in evaluating curative effect of TACE combined with HIFU for treating primary hepatocellular carcinoma（HCC）. Methods Fifty-four patients with HCC in TACE group, 41 patients in HIFU group and 22 patients in combined group were enrolled. All patients were examined using contrast- enhanced ultrasonography before and one week after therapy. Residual blood supply and missed lesions inside tumor tissues were observed. The lesion of incomplete deactivation were treated by HIFU in time. Results Contrast-enhanced ultrasonography showed that tumor inactivated rates were lower in TACE group and HIFU group than that in combined group, and tumor residual rates were significantly higher in TACE group and HIFU group than that in combined group （P〈0.05）. In combined group, six months, one-year and two-year survival rates were 100%,90.9% and 81.8%, respectively. They were higher than those in TACE or HIFU group （P〈0.05）. Conclusion Contrast-enhanced uhrasonography can accurately evaluate curative effect of treating HCC. Curative effect of TACE combined with HIFU for treating HCC is much better than TACE or HIFU treatment.