微创介入治疗复发性肝癌临床疗效分析

Clinical curative effect of minimally invasive interventional treatment on recurrent liver cancer

目的:评价经皮肝穿射频消融术(PRFA)联合肝动脉化疗碘油栓塞术(TACE)介入治疗复发性肝癌的临床效果,为临床制定以及选择治疗方法提供依据。方法:收集复发性肝癌患者临床资料70例,均行超声引导下PRFA联合TACE介入治疗。分析其近期临床治疗疗效并随访生存情况。结果:近期有效率(CR+PR)为85.71%,甲胎蛋白(AFP)转阴率为75.0%,AFP下降超过50%者为95.83%,术后均有不同程度的消化道反应、肝脏生化指标改变等,6例发生较重并发症(肝功能衰竭1例、腹水2例、胆囊炎3例),经积极纠正无治疗期死亡。6个月、12个月、24个月生存率分别为76.3%、52.6%、34.2%。结论:PRFA联合TACE治疗无手术适应征的复发性肝癌近期疗效确切,可获得满意的远期生存时间,是非手术综合治疗中安全有效的方法之一,值得临床推广。

Objective： To evaluate the clinical efficacy of percutaneous radiofrequency ablation （PRFA） combined with transcatheter arterial ehemoembolization （TACE） in the treatment of postoperative recurrence of primary hepatic carcinoma and provide a basis for the selection of clinical treatment. Methods： Clinical data of 70 patients with recurrent hepatic carcinoma after underwent hepatectomy with complete resection of tumor were collected. The interventional therapy that combined ultrasound-guided PRFA with TACE was applied to the recurring patients. Recent clinical efficacy and survival rates were analyzed. Results： Recent clinical efficacy rate （complete relief ＆ partial relief） was 85.71% while the negative conversion rate and 50% descending rate of AFP were 75.0% and 95.83%, respectively. All cases had different degrees of the digestive tract reaction, hepatic postoperative biochemical index change, etc. Six cases had more severe complications （liver failure in 1 case, ascites in 2 cases, cholecystitis in 3 cases）, with no mortality after active treatment during therapy period. The survival rates in 6, 12, 24 months were 76.3%, 52.6%, 34.2%, respectively. Conclusion： The recent clinical efficacy of PRFA combined with TACE in the treatment of recurrent liver cancer is reliable, with convinced long-term survival. The interventional therapy that combines PRFA with TACE, serving as one of the safe and effective non-surgical treatment means, would be recommended.