超声引导下经皮微波消融与肝动脉化疗栓塞治疗原发性肝癌的临床效果

Clinical Effects of Ultrasound-guided Percutaneous Microwave Ablation and Transcatheter Arterial Chemoembolization for Primary Liver Cancer

目的探讨超声引导下经皮微波消融与肝动脉化疗栓塞治疗原发性肝癌的临床效果。方法选择原发性肝癌患者86例作为研究对象,根据随机数字表法分为观察组与对照组各43例,对照组给予肝动脉化疗栓塞治疗,观察组给予超声引导下经皮微波消融治疗,记录两组近远期预后。结果两组治疗前ALT、AST水平比较均无明显差异(P>0.05),治疗后5 d观察组的ALT、AST水平明显低于对照组(P<0.05)。观察组与对照组的治疗总有效率分别为76.7%和53.5%,观察组的总有效率明显高于对照组(P<0.05)。两组治疗后3个月的感染、高热、腹水、消化道出血等并发症发生情况与对照组比较差异无统计学意义(P>0.05)。观察组治疗后6个月及1年的死亡率分别为2.3%与7.0%,对照组分别为14.0%和27.9%,观察组明显低于对照组(P<0.05)。结论相对于肝动脉化疗栓塞,超声引导下经皮微波消融治疗原发性肝癌也具有很好的安全性,对肝脏损害较轻,能提高治疗效果,延长患者的生存时间。

Objective To investigate the clinical effects of ultrasound-guided percutaneous microwave ablation and tran- scatheter arterial chemoembolization in the treatment of primary liver cancer. Methods 36 cases of primary liver cancer patients were selected as the research object, all the cases were randomly divided into the observation group and the control group, with 43 cases in each group. The control group received transcatheter arterial chemoembolization therapy, the observation group received ultrasound guided percutaneous microwave ablation treatment, The short-term and long-term prognosis in the 2 groups were recor- ded. Results There were no significant difference in the levels of ALT and AST compared between the 2 groups before treatment （P 〉 0. 05）. The ALT and AST levels in the observation group after treatment 5d were significantly lower than those of the control group （ P 〈 0.05 ）. The total effective rate of the observation group and the control group were 76.7% and 53.4%, respectively. The total effective rate of the observation group was significantly higher than that of the control group （P 〈 0.05）. There were no significant difference compared between the 2 groups in the treatment of infection, high fever, ascites, gastrointestinal bleeding and other complications 3 months after treatment （P 〉 0.05 ）. The 6-month and 1-year mortality rates of the observation group were 2.3% and 7.0% ,and the control group were 14% and 27.9% ,respectively. The observation group was significantly lower than that of the control group （P 〈 0.05）. Conclusion Compared with hepatic artery chemoembolization, ultrasound guided percuta- neous microwave ablation for hepatocellular carcinoma also has good safety, it has less damage to the liver, and can improve the therapeutic effect and prolong the survival time of patients.