TACE联合微波消融治疗消化道肿瘤肝转移的疗效分析

The clinical efficacy analysis of the treatment of liver metastases of the gastrointestinal tumor by the combination of Transcatheter hepatic arterial chemoembolization and Percutaneous microwave coagulation therapy

目的探讨经导管肝动脉化疗栓塞术(TACE)联合经皮微波消融(PMCT)序贯治疗消化道肿瘤肝转移的临床效果。方法选取我院2012年1月至2015年5月收治的126例消化道肿瘤肝转移患者,随机分为两组,对照组:拟行TACE治疗;观察组:采取TACE联合PMCT治疗。两组患者术后1个月均复查相关血液指标及增强CT,观察分析临床疗效,记录术后患者的不良反应,然后随访6、12、18及24个月时生存率。结果观察组总有效率为85.71%显著高于对照组的57.14%(P<0.01),随访6、12、18及24个月时生存率均明显高于对照组同期(P<0.05)。两组治疗均未出现严重并发症。结论对于消化道肿瘤肝转移患者应用TACE联合PMCT治疗可显著提高近期临床疗效,延缓病情发展,改善患者预后,提高病人术后生存率,且不良反应发生率较低,是临床对消化道肿瘤肝转移的一种有效、安全的治疗方法。

Objective To investigate the clinical effect of transcatheter hepatic arterial chemoembolization（TACE） combining with percutaneous microwave ablation（PMCT） in the treatment of hepatic metastasis of gastrointestinal tumors. Methods 126 patients with hepatic metastases, who were admitted from January 2012 to May 2015, were randomly divided into two groups according to the random numerical table method. Controlled group： TACE treatment; experimented group： TACE joint therapy of TACE and PMCT. In the following month, the two groups of patients＂ blood index and enhanced CT were examined, clinical curative effects were observed, postoperative adverse reactions were recorded, and they were followed up respectively with 6, 12, 18 and 24 months later for the survival rate. Results A total effective rate of 85.71% in experimented group is significantly higher than that of the controlled group＇ s 57.14% （ P 〈 0.01 ） and when followed up for 6, 12, 18 and 24 months their survival rates were siguifieantly higher than the same period in the controlled group （ P 〈 0.05 ）. There were no serious complications in both groups. Conclusion Gastrointestinal cancer patients with liver metastases should be treated with the combination of TACE and PMCT, which is an effective and safe treatment method that can significantly increase the recent clinical curative effect, delay the progression and improve prognosis of patients, im- prove the paticntg postoperative survival rate, and produce a lower incidence of adverse reactions. It is an effective and sale treatment for the digestive tract tumor spread to the liver.