超声新技术辅助大血管旁小肝癌精准微波消融治疗效果观察

A novel treatment on small hepatocellular carcinoma adjacent to large vessels by ultrasound assisted precision microwave ablation

目的观察超声新技术辅助大血管旁小肝癌精准微波消融治疗效果。方法选取西安宝石花长庆医院收治的大血管旁小肝癌患者76例,依据所选手术方式的不同分为对照组(手术切除治疗)36例和研究组(超声新技术辅助下的微波消融治疗)40例。对比两组患者手术时间、住院时间、并发症发生情况及术后1个月手术切除率。随访1年,对比两组患者术后1年肿瘤进展发生率及生存情况。结果研究组手术时间、住院时间均短于对照组分别为(92.45±15.28)min比(138.41±28.35)min、(6.12±1.47)d比(10.06±2.13)d(t=8.918、9.463,均P<0.05)。研究组住院期间并发症发生率低于对照组,2.78%(1/36)比17.50%(7/40)(χ^(2)=4.360,P=0.037)。对照组、研究组病灶切除率为100%(36/36)比95%(38/40),差异无统计学意义(χ^(2)=1.849,P=0.174)。对照组、研究组术后1年肿瘤进展发生率为16.67%(6/36)比17.50%(7/40),差异无统计意义(χ^(2)=0.009,P=0.923)。对照组、研究组术后1年生存率为83.33%(30/36)比80.00%(32/40),差异无统计学意义(χ^(2)=0.165,P=0.684)。结论超声新技术辅助大血管旁小肝癌精准微波消融治疗可达到与手术切除相同的治疗效果,但手术及住院时间较短,并发症相对较少。

Objective To observe the effect of a novel ultrasound technology assisted precise microwave ablation for small hepatocellular carcinoma adjacent to large vessels.Methods A total of 76 patients with small hepatocellular carcinoma near large blood vessels who were admitted to Xi’an Baoshihua Changqing Hospital were selected and divided into a control group(with surgical resection,n=36 cases)and a study group(with microwave ablation treatment assisted by new technology of ultrasound,n=40 cases)according to the different surgical regimes selected.The operation time,hospital stay,incidence of complications and 1month postoperative resection rate were compared between the two groups.The patients were followed up for 1 year,and the incidence of tumor progression and survival at 1 year after surgery were compared.Results The operation time and hospital stay in the study group were shorter than those of the control group[(92.45±15.28)min vs(138.41±28.35)min,and(6.12±1.47)d vs(10.06±2.13)d,respectively](t=8.918,9.463,all P<0.05).The incidence of complications during hospitalization in the study group(2.78%vs 17.50%)was lower(χ^(2)=4.360,P=0.037).The surgical resection rates of the control group and the study group(2.78%vs 17.50%)were similar(χ^(2)=1.849,P=0.174).The incidence of tumor progression at 1 year after operation in the control group and the study group was similar(16.67%vs 17.50%)(χ^(2)=0.009,P=0.923).The 1-year survival rates of the control group and the study group were similar(83.33%vs 80.00%)(χ^(2)=0.165,P=0.684).Conclusion The treatment of ultrasound technology assisted precise microwave ablation for small liver cancer adjacent to large vessels can achieve the same therapeutic effect as surgical resection,with shorter operation time and hospital stay,as well as relatively less complications.