MWA联合TACE治疗PHC合并PVTT患者的疗效及安全性分析

Analysis of the Efficacy and Safety of MWA Combined with TACE in the Treatment of PHC Patients with PVTT

目的:探究微波消融(MWA)联合经肝动脉插管化疗栓塞术(TACE)治疗原发性肝癌(PHC)合并门静脉癌栓(PVTT)患者的疗效及安全性。方法:选取莆田市第一医院2016年2月至2021年2月收治的50例PHC合并PVTT患者作为研究对象,采用随机数表法分为观察组和对照组,各25例。对照组采用TACE治疗措施,观察组给予MWA联合TACE进行治疗。比较两组患者的临床疗效、生存情况、不良反应及并发症发生率。结果:观察组患者客观缓解率明显高于对照组,差异具有统计学意义(P<0.05)。两组患者在治疗后3 d内均出现发热、呕吐、肝部疼痛等不良反应,其中观察组患者在治疗后出现穿刺点血肿、消化道出血症状,对照组患者在治疗后出现消化道出血、肿瘤破裂出血症状,两组患者均未发生肝脓肿、溶瘤综合征现象,两组患者不良反应及并发症发生率比较,差异无统计学意义(P>0.05)。结论:给予PHC合并PVTT患者MWA联合TACE治疗,能够有效提高临床疗效,在治疗期间也具有足够的医疗安全性。

Objective To explore the efficacy and safety of microwave ablation (MWA) combined with transhepatic artery intubation chemoembolization (TACE) in the treatment of patients with primary hepatic cancer (PHC) and portal vein tumor thrombus (PVTT).Methods 50 patients with PHC combined with PVTT who were admitted to Putian First Hospital from February 2016 to February 2021 were selected as the research objects.The random number table method was used to divide them into an observation group and a control group,with 25 cases in each group.The control group was treated with TACE,and the observation group was treated with MWA combined with TACE.The clinical efficacy,survival,adverse reactions and complication rates of patients the two groups of were compared.Results The objective remission rate of patients in the observation group was significantly higher than that in the control group,and the difference was statistically significant (P < 0.05).The patients of two groups all developed fever,vomiting,liver pain and other adverse reactions within 3 days after treatment.Patients in the observation group developed puncture site hematoma and gastrointestinal hemorrhage after treatment,while patients in the control group developed gastrointestinal hemorrhage and tumor after treatment.There was no hepatic abscess or oncolytic syndrome in the two groups with rupture and bleeding symptoms.There was no statistically significant difference in the incidence of adverse reactions and complications between the two groups(P > 0.05).Conclusion The treatment of MWA combined with TACE for PHC patients with PVTT can effectively improve the clinical efficacy and has sufficient medical safety during the treatment period.