肝动脉化疗栓塞联合B超引导下微波消融治疗原发性肝癌患者的临床研究

Clinical trial of transcatheter arterial chemoembolization combined with B-ultrasound guided microwave ablation in the treatment of patients with primary liver cancer

目的观察肝动脉化疗栓塞(TACE)联合B超引导下微波消融治疗对原发性肝癌患者预后影响。方法将原发性肝癌患者作为研究对象,按照治疗方案分为对照组与试验组,分别给予TACE治疗、TACE结合B超引导下微波消融治疗。比较2组治疗有效率,治疗前后肝功能指标,肿瘤标志物水平,治疗后药物不良反应及预后情况。结果试验组纳入33例,对照组纳入27例。治疗后,试验组与对照组患者客观缓解率分别为78.79%(26例/33例)和48.15%(13例/27例);总胆红素分别为(27.26±1.47)和(23.43±2.58)μmol·L^(-1);谷草转氨酶分别为(47.49±5.22)和(42.52±5.35)U·L^(-1),组间比较,差异均有统计学意义(均P<0.05)。治疗后,试验组与对照组的癌胚抗原分别为(3.65±0.62)和(5.84±0.74)ng·mL^(-1);糖蛋白抗原125分别为(18.46±2.18)和(42.86±3.52)ng·mL^(-1);糖蛋白抗原19-9分别为(18.11±4.26)和(24.56±3.67)ng·mL^(-1);甲胎蛋白分别为(0.86±0.29)和(1.52±0.38)ng·mL^(-1),组间比较,差异均有统计学意义(均P<0.05)。试验组与对照组药物不良反应总发生率分别为42.42%(14例/33例)和33.33%(9例/27例),差异无统计学意义(P>0.05)。试验组与对照组患者1年复发率分别为6.06%(2例/33例)与29.63%(8例/27例),2组比较,差异有统计学意义(P<0.05)。结论TACE联合B超引导下微波消融治疗原发性肝癌疗效及安全性好。

Objective To investigate the prognosis of transcatheter arterial chemoembolization(TACE)combined with B-ultrasound guided microwave ablation in the treatment of patients with primary liver cancer.Methods Patients with primary liver cancer were selected as research subjects and divided into control group and treatment group according to treatment methods.The control group and treatment group were given TACE therapy and TACE combined with microwave ablation guided by B-ultrasound,respectively.The effective rate of treatment,liver function indexes before and after treatment,tumor marker levels,adverse drug reactions and prognosis after treatment were compared between the two groups.Results The treatment group included 33 cases and the control group included 27 cases.After treatment,the objective remission rates in the treatment group and the control group were 78.79%(26 cases/33 cas es)and 48.15%(13 cases/27 cases);the levels of total bilirubin were(27.26±1.47)and(23.43±2.58)μmol·L^(-1);the levels of glutamic-oxaloacetic transaminase were(47.49±5.22)and(42.52±5.35)U·L^(-1),the differences between the two groups were statistically significant.(all P<0.05).After treatment,the levels of carcinoembryonic antigen in the treatment group and the control group were(3.65±0.62)and(5.84±0.74)ng·mL^(-1);the levels of glycoprotein antigen 125 were(18.46±2.18)and(42.86±3.52)ng·mL^(-1);the levels of glycoprotein antigen 19-9 were(18.11±4.26)and(24.56±3.67)ng·mL^(-1);the levels of alpha-fetoprotein were(0.86±0.29)and(1.52±0.38)ng·mL^(-1),the differences between the two groups were statistically significant(all P<0.05).The total incidence rates of adverse drug reactions in the treatment group and the control group were 42.42%(14 cases/33 cases)and 33.33%(9 cases/27 cases),the difference was not statistically significant(P>0.05).The 1-year recurrence rates in the treatment group and the control group were 6.06%(2 cases/33 cases)and 29.63%(8 cases/27 cases),the differences between the two groups were statistically significant.(P<0.05).Conclusion TACE combined with B-ultrasound guided microwave ablation is effective and safe in the treatment of primary hepatic carcinoma.