超声引导下射频消融与手术切除治疗涎腺混合瘤的对比研究

Comparative study on the curative effect of ultrasound-guided radiofrequency ablation and surgical excision in the treatment of salivary gland mixed tumor

目的对比超声引导下射频消融(RFA)与外科手术切除对直径≤3 cm涎腺混合瘤的治疗效果, 分析RFA在涎腺混合瘤治疗中的可行性及临床应用价值。方法纳入2020年3月至2022年3月在郑州大学第一附属医院接受治疗的直径≤3 cm的涎腺混合瘤患者43例进行回顾性研究, 根据治疗方式分为消融组20例和切除组23例。评估消融组手术的完全消融率;记录消融组术后消融灶吸收情况;对比两组患者的部分围手术期指标、术后并发症发生率;随访观察两组患者的长期预后, 统计复发和恶变转移的发生率以及外貌恢复情况。结果消融组病灶的完全消融率为100%(20/20)。消融组术后1、3、6、12个月的病灶体积缩小率依次为-(39.60±16.18)%、(8.61±8.10)%、(31.87±14.68)%、(58.64±14.82)%。消融组手术时间、恢复进食时间、术后住院时间以及术中出血量少于切除组, 差异有统计学意义(均P<0.001)。消融组术后发生并发症2例, 切除组发生并发症9例, 两组术后并发症总发生率比较, 差异有统计学意义(χ^(2)=4.768, P=0.029)。消融组复发1例, 术后1年面部凹陷或凸起的发生率均为0。切除组无复发, 术后1年面部凹陷的发生率为13.04%(3/23), 面部凸起的发生率为0。两组患者均无恶变转移。结论超声引导下RFA治疗直径≤3 cm涎腺混合瘤安全有效, 治疗效果与外科手术切除相比无明显差异, 且创伤小, 美容效果好, 具有很大的应用前景。

Objective To compare the therapeutic effects of ultrasound-guided radiofrequency ablation(RFA)and surgical resection on salivary gland mixed tumor with diameter≤3 cm,and to analyze the feasibility and clinical value of RFA in the treatment of salivary gland mixed tumor.Methods A retrospective study was conducted on 43 patients with salivary gland mixed tumor whose diameter≤3 cm were treated in the First Affiliated Hospital of Zhengzhou University from March 2020 to March 2022.According to the treatment method,they were divided into an ablation group of 20 cases and a resection group of 23 cases.The complete ablation rate of the ablation group was evaluated,the postoperative absorption of ablation foci in the ablation group was recorded,and the perioperative indexes and the incidence of postoperative complications of the two groups were compared.The long-term prognosis of the two groups was followed up,and the incidence of recurrence,malignant metastasis and appearance recovery were evaluated.Results In the ablation group,the complete ablation rate was 100.00%(20/20).The lesion volume reduction rates at 1,3,6 and 12 months after operation were-(39.60±16.18)%,(8.61±8.10)%,(31.87±14.68)%and(58.64±14.82)%,respectively.The operation time,recovery feeding time,postoperative hospital stay and intraoperative bleeding in the ablation group were less than those in the resection group,and the differences were statistically significant(all P<0.001).Postoperative complications occurred in 2 cases in the ablation group and 9 cases in the resection group.There was significant difference in the total incidence of postoperative complications between the two groups(χ^(2)=4.768,P=0.029).There was 1 case of recurrence in the ablation group,and no facial depression or protuberance occurred 1 year after operation.There was no recurrence in the resection group,one year after operation,the incidence of facial depression and facial protuberance was 13.04%(3/23)and 0,respectively.There was no malignant metastasis in both groups.Conclusions Ultrasound-guided RFA is safe and effective in the treatment of mixed tumors of salivary gland with diameter≤3 cm,and the therapeutic effect is not significantly different from that of surgery.With minimal trauma and good cosmetic effect,it has a great application prospect.