探讨CT引导下微波消融术对晚期第一肝门区肝癌患者的临床疗效

The clinical efficacy of microwave ablation under CT-guidance for patients with liver cancer of the first hepatic hilar region at advanced period

目的:探讨CT引导下微波消融术对丧失手术治疗机会的晚期第一肝门区肝癌患者的临床疗效。方法:选取医院收治的56例丧失手术治疗机会的晚期第一肝门区肝癌患者,采用随机数表法将其分为观察组与对照组,每组28例。观察组患者接受CT引导下的微波消融术等靶向综合疗法,对照组则接受常规动脉栓塞化疗法,比较两组患者治疗效果及生存情况。结果:观察组肝癌患者治疗总有效率为82.14%,明显高于对照组的46.43%,两组比较差异有统计学意义(x^2=7.778,P<0.05);两组患者治疗后甲胎蛋白(AFP)水平明显降低,但观察组患者AFP改善程度明显优于对照组,两组比较差异有统计学意义(t=14.662,P<0.0,5);观察组患者术后1~2年生存率略高于对照组,但两组比较差异无统计学意义(x^2=4.156,x^2=0.080;P>0.05);治疗过程中及治疗后观察组患者不良反应发生率明显低于对照组,两组比较差异有统计学意义(x^2=6.842,P<0.05)。结论:CT引导下微波消融术等综合靶向疗法具有操作简单、治疗精准的优点,对丧失手术时机的晚期第一肝门区肝癌患者具有良好疗效,并且不良反应较轻,较传统动脉栓塞术具有明显的治疗优势。

Objective:To explore the clinical efficacy of microwave ablation under CT-guidance for patients withliver cancer of the first hepatic hilar region at advanced period.Methods:56patients with liver cancer of thefirst hepatic hilar region at advanced period,who had lost the chance of operative treatment,were divided intoobservation group(28cases)and control group(28cases)as the random number table.The patients of observationgroup received CT-guidance microwave ablation and other targeted combining therapy while patients of controlgroup underwent routine chemotherapy of arterial embolism.The therapeutic effect and survival situation of the twogroups were compared and analyzed.Results:The total effective rate of patients with liver cancer of the observationgroup(82.14%)was significantly higher than that of control group(46.43%)(x2=7.778,P<0.05).The AFP of bothof the two group was obviously reduced,and the improvement degree of observation group was significantly betterthan that of control group(t=14.662,P<0.05).The survival rate of post-operative1-2y of observation group wasslightly higher than that of control group,but it was no significant(x2=4.156,x2=0.080,P>0.05).During the processof treatment and post the process of treatment,the occurrence rate of adverse reaction of observation group wassignificantly lower than that of control group(x2=6.842,P<0.05).Conclusion:The microwave ablation under CTguidanceand other targeted combining therapy has outstanding advantages including simple operation,curativeprecision and so on.And it has better curative effect for patients with liver cancer of the first hepatic hilar region atadvanced period who had lost optimum opportunity of operative treatment.Besides,its adverse reaction is lower andit has obviously preponderance to compare with routine arterial embolism.