水隔离技术辅助射频消融治疗邻近肝表面肝细胞癌的临床研究

Liquid isolation assisted technique in radiofrequency ablation for hepatocellular carcinoma near liver surfaces

目的探讨水隔离技术辅助超声引导经皮射频消融治疗邻近肝表面肝细胞癌的安全性及疗效。方法回顾分析郑州大学附属肿瘤医院肝胆胰腺外科2016年11月至2019年11月行射频消融治疗邻近肝表面肝细胞癌246例患者临床资料,其中男性182例,女性64例,年龄(56.7±9.2)岁。246例患者中131例采用水隔离技术辅助射频消融治疗纳入水隔离组,115例采用常规射频消融纳入常规治疗组。对比两组并发症情况、一次性完全消融率及无进展生存率等。结果水隔离组术中并发症发生率21.4%(28/131),常规治疗组20.9%(24/115),两组比较差异无统计学意义(P>0.05)。水隔离组术后并发症发生率20.6%(27/131),低于常规治疗组33.9%(39/115),差异有统计学意义(P<0.05)。水隔离组术后疼痛发生率6.1%(8/131),低于常规治疗组15.6%(18/115),差异有统计学意义(P<0.05)。水隔离组131例患者邻近肝表面肿瘤183个,常规治疗组115例患者邻近肝表面肿瘤142个。水隔离组一次完全消融率94.0%(172/183),高于常规治疗组75.4%(107/142),差异有统计学意义(P<0.05)。水隔离组无进展生存率优于常规治疗组,差异有统计学意义(P<0.05)。结论水隔离技术可增加邻近肝表面肝细胞癌射频消融的一次完全消融率,降低术后并发生发生率,改善患者预后。

Objective To study the safety and efficacy of liquid isolation assisted technology in ultrasound-guided percutaneous radiofrequency ablation for hepatocellular carcinoma adjacent to liver surfaces.Methods A retrospective study was conducted on 246 patients with hepatocellular carcinoma near liver surfaces treated by radiofrequency ablation from November 2016 to November 2019 at the Department of Hepatobiliary and Pancreatic Surgery,Affiliated Tumor Hospital of Zhengzhou University.There were 182 males and 64 females,aged(56.7±9.2)years.The patients were divided into the liquid isolation group with liquid isolation assisted technology for radiofrequency ablation(n=131)and the conventional treatment group with conventional radiofrequency ablation(n=115).The complication,one-time complete ablation and progression-free survival rates were compared between the two groups.Results The incidence of intraoperative complications in the liquid isolation group was 21.4%(28/131),versus 20.9%(24/115)in the conventional treatment group.There was no significant difference between the two groups(P>0.05).The incidence of postoperative complications in the liquid isolation group was 20.6%(27/131),which was significantly lower than that in the conventional treatment group 33.9%(39/115)(P<0.05).The incidence of postoperative pain in the liquid isolation group was 6.1%(8/131),which was significantly lower than that in the conventional treatment group 15.7%(18/115)(P<0.05).For the 131 patients in the liquid isolation group,there were 183 tumors near to liver surfaces.For the 115 patients in the conventional treatment group,there were 142 lesions near to liver surfaces.The one-time complete ablation rate in the liquid isolation group was 94.0%(172/183),which was significantly higher than the 75.4%(107/142)in the conventional treatment group(P<0.05).The progression-free survival rate in the liquid isolation group was significantly better than that in the conventional treatment group(P<0.05).Conclusion The liquid isolation technique increased the one-time complete ablation rate of liver cancer adjacent to liver surfaces,reduced the incidence of postoperative complications and improved prognosis.