超声引导下经皮穿刺微波消融、经导管动脉化疗栓塞治疗原发性肝癌的临床疗效比较

Comparison of clinical efficacy of ultrasound-guided percutaneous microwave ablation and transcatheter arterial chemoembolization in the treatment of primary liver cancer

目的比较超声引导下经皮穿刺微波消融、经导管动脉化疗栓塞治疗原发性肝癌的临床疗效。方法根据治疗方法的不同将92例原发性肝癌患者分为对照组(n=45,经导管动脉化疗栓塞)和观察组(n=47,超声引导下经皮穿刺微波消融)。比较两组患者的临床疗效、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]、并发症发生情况及生存情况。结果观察组患者的总有效率为76.60%,高于对照组患者的55.56%,差异有统计学意义(P<0.05)。治疗后,两组患者的ALT、AST水平均高于本组治疗前,观察组患者的ALT、AST水平均低于对照组,差异均有统计学意义(P<0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P﹥0.05)。治疗后6个月、1年,观察组患者的生存率均高于对照组,差异均有统计学意义(P<0.05)。结论与经导管动脉化疗栓塞相比,超声引导下经皮穿刺微波消融治疗原发性肝癌患者能够提高治疗效果和生存率,减轻肝功能损伤,且未增加并发症发生率。

Objective To compare the clinical efficacy of ultrasound-guided percutaneous microwave ablation and transcatheter arterial chemoembolization in the treatment of primary liver cancer.Method A total of 92 patients with primary liver cancer were divided into control group(n=45,received transcatheter arterial chemoembolization)and observation group(n=47,received ultrasound-guided percutaneous microwave ablation)according to different treatment methods.The clinical efficacy,liver function indicators[alanine aminotransferase(ALT),aspartate transaminase(AST)],complications and survival were compared between the two groups.Result The total effective rate of the observation group was 76.60%,higher than 55.56% of the control group(P<0.05).After treatment,the levels of ALT and AST in the two groups were higher than those before the treatment,with lower levels in the observation group than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The survival rate at 6 months and 1 year after treatment in the observation group were higher than those in the control group(P<0.05).Conclusion Compared with transcatheter arterial chemoembolization,ultrasound-guided percutaneous microwave ablation in the treatment of primary liver cancer can improve the treatment effect and survival rate,reduce liver function damage without increase of complications.