超声引导下聚桂醇原液硬化治疗联合射频消融在肝血管瘤中的应用

Ultrasound-guided cinnamol sclerotherapy combined with radiofrequency ablation for hepatic hemangioma

目的探讨超声引导下聚桂醇原液硬化治疗联合射频消融在肝血管瘤中的应用。方法 收集2016年7月至2018年6月的48例肝血管瘤患者的临床资料,应用随机数字表法随机分为对照组和联合组,各24例。其中对照组给予超选择性肝血管瘤动脉注射平阳霉素碘油乳剂栓塞治疗,联合组给予超声引导下聚桂醇原液硬化治疗联合射频消融治疗。比较分析两组患者和治疗6个月后的临床疗效、血管瘤残留、复发率、出血量、住院时间和不良反应发生情况,对比其治疗前和和治疗6个月后的瘤体最大长径、最大截面积。结果 联合组治疗6个月后的总有效率明显高于对照组(95.83%比70.83%),差异有统计学意义(χ^2=5.400,P=0.020);两组患者治疗前的瘤体最大长径、最大截面积比较差异无统计学意义(P>0.05);治疗6个月后,瘤体最大长径、最大截面积均明显下降(P<0.05),且联合组明显低于对照组,差异有统计学意义(P<0.05);联合组患者术后的血管瘤残留、复发率、出血量明显低于对照组,住院时间明显短于对照组,差异均有统计学意义(均P<0.05);联合组的不良反应发生率为8.33%(2/24);对照组的不良反应发生率为8.33%(2/24),差异无统计学意义(χ^2=0.000,P=1.000)。结论 应用超声引导下聚桂醇原液硬化治疗联合射频消融对肝血管瘤患者进行治疗,临床效果显著,明显减少患者瘤体体积,降低复发率,且安全性较高。

Objective To explore the effect of ultrasound-guided cinnamol sclerotherapy combined with radiofrequency ablation in the treatment of hepatic hemangioma. Methods The clinical data of 48 patients with hepatic hemangioma treated at our hospital from July, 2016 to June, 2018 were collected, and were randomly divided into a control group and a combined group, 24 cases for each group. The control group was treated with superselective intra-arterial embolization of hepatic hemangioma with pingyangmycin lipiodol emulsion, and the combined group was treated with ultrasound-guided cinnamol sclerotherapy and radiofrequency ablation. The clinical efficacies, residual hemangioma, recurrence rates, bleeding volumes, hospitalization times, and adverse reactions of the two groups were compared and analyzed. The maximum lengths and cross-sectional areas of the hemangioma before and 6 months after the treatment were compared. Results The total effective rate of after 6 months’ treatment was significantly higher in the combined group than in the control group (95.83% vs. 70.83%,χ^2=5.400, P=0.020). There were no statistical differences in the maximum length and cross-sectional area of the tumors between the two groups before the treatment (both P > 0.05). After 6 months’ treatment, the maximum length and the maximum cross-sectional area decreased significantly in both groups (P < 0.05), and were significantly lower in the combined group than in the control group (P < 0.05). The residual hemangioma,recurrence rate, and bleeding volume were significantly lower and the hospitalization time was significantly shorter in the combined group than in the control group (P < 0.05). The incidence of adverse reactions was 8.33%(2/24) in the combined group, and 8.33%(2/24) in the control group, with no statistical difference (χ^2=0.000, P=1.000). Conclusion Ultrasound-guided cinnamol sclerotherapy combined with radiofrequency ablation for patients with hepatic hemangioma has a significant clinical effect and a high safety, and can significantly reduce the tumor volume and recurrence rate.