超声引导下经皮射频消融术联合经导管动脉化疗栓塞术治疗原发性肝癌的临床价值研究

Clinical value of ultrasound-guided percutaneous radiofrequency ablation combined with transcatheter arterial chemoembolization in the treatment of primary liver cancer

目的探讨超声引导下经皮射频消融术(RFA)联合经导管动脉化疗栓塞术(TACE)治疗原发性肝癌的临床价值。方法选取118例原发性肝癌患者,根据治疗方案不同分为对照组(n=61)和观察组(n=57),对照组采用TACE治疗,观察组采用TACE+RFA治疗。比较两组患者的近期疗效、肝功能指标及并发症发生情况。结果观察组患者的总有效率为85.96%(49/57),高于对照组患者的68.85%(42/61),差异有统计学意义(P﹤0.05);观察组患者疾病控制率为92.98%(53/57),高于对照组患者的78.69%(48/61),差异有统计学意义(P﹤0.05)。治疗后,两组患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及总胆红素(TBIL)水平均明显低于本组治疗前,白蛋白(ALB)水平均明显高于本组治疗前,差异均有统计学意义(P﹤0.01);观察组患者ALT、AST及TBIL水平均明显低于对照组,ALB水平明显高于对照组,差异均有统计学意义(P﹤0.01)。两组患者并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论原发性肝癌患者采用TACE+RFA治疗有利于提高近期疗效,改善患者肝功能,且未增加严重不良反应,临床应用前景可观。

Objective To explore the clinical value of ultrasound-guided percutaneous radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer.Method A total of 118 patients with primary liver cancer were selected.They were divided into control group(n=61)and observation group(n=57)according to different treatment schemes.The control group was treated with TACE,and the observation group was treated with TACE+RFA.The short-term efficacy and liver function indexes after treatment between the two groups were compared,the incidence of complications in the two groups were observed.Result The total effective rate of the observation group was 85.96%(49/57),which was significantly higher than 68.85%(42/61)of the control group,the difference was statistically significant(P<0.05).The disease control rate of the observation group was 92.98%(53/57),which was significantly higher than 78.69%(48/61)of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)of the two groups of patients were significantly lower than those before treatment,the levels of albumin(ALB)of the two groups of patients were significantly higher than those before treatment,the differences were statistically significant(P<0.01);the levels of ALT,AST and TBIL in the observation group were significantly lower than those of the control group,the ALB level was significantly higher than that of the control group,the differences were statistically significant(P<0.01).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion TACE+RFA in the treatment of patients with primary liver cancer is beneficial to improving the short-term curative effect and improving the liver function of the patients and it does not increase serious adverse reactions.The clinical application prospects are considerable.