三维可视化辅助经肝动脉插管化疗栓塞术联合微波消融治疗中晚期肝癌的临床研究

Clinical study of three-dimensional visualizationassisted transcatheter arterial chemoembolization combined with microwave ablation in the treatment of advanced liver cancer

目的探究三维可视化辅助经肝动脉插管化疗栓塞术(TACE)联合微波消融(MWA)治疗中晚期肝癌的临床价值。方法选取2019年1月至2022年4月赣州市第五人民医院收治的30例接受三维可视化辅助TACE联合MWA治疗的中晚期肝癌患者作为观察组,并选取既往同一医院接受单纯接受TACE联合MWA治疗的30例中晚期肝癌患者作为对照组。比较两组肿瘤坏死、复发情况、临床疗效、肝功能及远期疗效。结果观察组肿瘤术后1个月完全坏死率高于对照组,术后3个月部分坏死率、随访12个月复发率均低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率、疾病控制率分别为80.00%、93.33%,高于对照组的53.33%、73.33%,差异有统计学意义(P<0.05)。治疗后2周,观察组白蛋白(ALB)、总蛋白(TP)水平均高于对照组,总胆汁酸(TBA)、碱性磷酸酶(ALP)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、间接胆红素(IBIL)、直接胆红素(DBIL)、总胆红素(TBIL)和γ-谷氨酰转肽酶(γ-GCT)水平均低于对照组,差异有统计学意义(P<0.05)。观察组远期生存率高于对照组,差异有统计学意义(P<0.05);治疗后12个月,观察组生命质量(QOL)评分高于对照组,差异有统计学意义(P<0.05)。结论三维可视化辅助TACE联合MWA治疗中晚期肝癌效果显著,可提升患者肿瘤清除率,增强肿瘤控制效果,降低复发率,改善患者肝功能指标及生命质量,提升远期生存率,值得临床推广应用。

Objective To explore the clinical value of three-dimensional visualization-assisted transcatheter arterial chemoembolization(TACE)combined with microwave ablation(MWA)in the treatment of advanced liver cancer.Methods 30 patients with advanced liver cancer who received three-dimensional visualization-assisted TACE combined with MWA in the Fifth People's Hospital of Ganzhou from January 2019 to April 2022 were selected as the observation group,and 30 patients with advanced liver cancer who received TACE combined with MWA alone in the same hospital were selected as the control group.The tumor necrosis,recurrence,clinical efficacy,liver function and long-term efficacy were compared between the two groups.Results The complete rate of the tumor necrosis in the observation group was higher than that in the control group at 1 month after operation,the partial necrosis rate at 3 months after operation and the recurrence rate at 12 months after follow-up were lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment and disease control rate in the observation group were 80.00% and 93.33%,respectively,which were higher than 53.33% and 73.33% in the control group,and the differences were statistically significant(P<0.05).2 weeks after treatment,the levels of albumin(ALB)and total protein(TP)in the observation group were higher than those in the control group,and the levels of total bile acid(TBA),alkaline phosphatase(ALP),aspartate aminotransferase(AST),alanine aminotransferase(ALT),indirect bilirubin(IBIL),direct bilirubin(DBIL),total bilirubin(TBIL)and γ-glutamyltranspeptidase(γ-GCT)were lower than those in the control group,the differences were statistically significant(P<0.05).The long-term survival rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After 12 months of treatment,the quality of life(QOL)score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Three-dimensional visualization assisted TACE combined with MWA visualization is effective in adjuvant treatment of advanced liver cancer,which can improve the tumor clearance rate,enhance the tumor control effect,reduce the recurrence rate,improve the liver function index and quality of life,and improve the longterm survival rate,it is worthy of clinical promotion and application.