目的评价体表心电图V1导联查颤动波(f波)振幅对射频消融治疗持续性心房颤动(简称房颤)疗效的预测作用。方法连续选取北京军区总医院心血管疾病研究所2010年3月至2013年12月间持续性房颤患者49例。根据随访结果分为两组:未复发组(33例)...目的评价体表心电图V1导联查颤动波(f波)振幅对射频消融治疗持续性心房颤动(简称房颤)疗效的预测作用。方法连续选取北京军区总医院心血管疾病研究所2010年3月至2013年12月间持续性房颤患者49例。根据随访结果分为两组:未复发组(33例)和复发组(16例)。根据射频消融术中肺静脉隔离后是否转为房扑(包括左房房扑或右房房扑)分为转为房扑组(10例)和未转为房扑组(39例)。测量接受导管射频消融术治疗持续性房颤患者体表心电图V1导联f波的最大振幅和平均振幅。比较两组患者f波最大振幅和平均振幅,并评价其对房颤复发和转为房扑的预测价值。结果与未复发组比较,复发组V1 f波最大振幅[(0.150±0.519)m V vs.(0.094±0.480)m V]和平均振幅[(0.125±0.50)m V vs.(0.077±0.032)m V]降低,差异有显著统计学意义(P均<0.01)。V1导联f波最大振幅及平均振幅的ROC曲线显示曲线下面积分别为0.77(P=0.002)和0.80(P=0.001)。预测术后复发的V1导联f波最大振幅的界值为0.115 m V,敏感性和特异性分别为75.8%和68.7%;平均振幅为0.094 m V,敏感性和特异性分别为78.8%和68.7%。与转为房扑组比较,未转为房扑组V1 f波平均振幅[(0.139±0.052)m V vs.(0.102±0.047)m V]降低,差异有统计学意义(P<0.05)。V1导联f波平均振幅的ROC曲线显示曲线下面积为0.71(P<0.05)。术中转为房扑平均振幅的界值为0.109 m V,敏感性和特异性分别为60%和61.5%。结论持续性房颤V1导联f波的振幅大小与射频消融术后的复发相关,振幅高者复发的可能性低。展开更多
AIM： To analyze the long-term prognosis in a cohort of western cirrhotic patients with single hepatocellular carcinoma treated with ethanol injection.METHODS： One-hundred forty-eight patients with solitan/hepatocell...AIM： To analyze the long-term prognosis in a cohort of western cirrhotic patients with single hepatocellular carcinoma treated with ethanol injection.METHODS： One-hundred forty-eight patients with solitan/hepatocellular carcinoma were enrolled. The tumor diameter was lower than 2 cm in 47 patients but larger in the remaining 101 patients. The impact of some pre- treatment clinical and laboratory parameters and of tu- mor recurrence on patients＇ survival was assessed.RESULTS： Among the pre-treatment parameters, only a tumor diameter of less than 2 cm was an independent prognostic factor of survival. The occurrence of new nodules in other liver segments and the neoplastic portal invasion were linked to a poorer prognosis at univariate analysis. Patients with a single hepatocellular carcinoma smaller than 2 cm showed a better 5-year cumulative survival （73.0% vs 47.9%） （P = 0.009）, 3-year local re- currence rate （29.1% vs 51.5%） （P = 0.011）, and 5-year distant intrahepatic recurrence rate （52.g% vs 62.8%） （P = 0.054） compared to patients with a larger tumor. CONCLUSION： The 5-year survival rate of patients with single hepatocellular carcinoma 〈 2 cm undergoing ethanol injection is excellent and comparable to that achieved using radiofrequency ablation.展开更多
Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods...Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods:From January 2009 to November 2011,a series of sixty-one patients were included in the study according to the criteria:each patient had one recurrent HCC,less than 5 cm in diameter.Twenty-six of the 61 patients were treated with PRFA and the other 35 were treated with repeat hepatectomy.Results:The interval from first surgery to recurrent for repeat hepatectomy and PRFA groups were(1,239.60±1,017.00) d and(903.42±975.11) d respectively(P=0.066).The tumor-free time after repeat hepatectomy and PRFA were(310.23±159.50) d and(278.27±123.29) d respectively(P=0.584).Size of tumor in repeat hepatectomy and PRFA were(7.34±3.16) cm^2 and(5.59±3.40) cm^2(P=0.215),the total expenditure for each patient of the two groups were(26,150.66±7,923.60) yuan and(21,135.00±1,156.76) yuan(RMB),and the time of hospitalization for each of the two groups were(15.29±4.28) d and(7.46±2.20) d(P<0.001).Conclusion:PRFA is proved to be as effective as repeat hepatectomy in the treatment of recurrent small HCC,and superior to repeat hepatectomy as it is less invasive.展开更多
Objective We studied the efficacy of salvage hepatectomy for treating recurrent hepatic cancer after radiofrequency ablation （RFA）. Methods A retrospective analysis of 67 patients who had recurrent liver cancer afte...Objective We studied the efficacy of salvage hepatectomy for treating recurrent hepatic cancer after radiofrequency ablation （RFA）. Methods A retrospective analysis of 67 patients who had recurrent liver cancer after RFA treatment and received salvage hepatectomy in the Department of Hepatobiliary Surgery, Southwest Hospital, Third Mili- tary Medical University （China）, from January 2006 to January 2014, was performed. The analysis included patient gender, age, hepatitis type, alpha-fetoprotein （AFP）, and TNM stage prior to RFA and salvage hepatectomy, overall survival rates, and tumor-free survival rates after salvage hepatectomy. Results Among the 67 patients, there were 57 cases of hepatitis B, two cases of hepatitis C, and eight cases did not have hepatitis. AFP levels in patients ranged from 3 to 4521 ng/mL （median 33 ng/mL）. Before RFA, 54 cases were stage I tumors, and 13 were stage II tumors. Tumor sizes varied from 0.82 to 4.83 cm （median 3.0 cm）. In 20 cases, one RFA was performed, and for 47 cases, RFA was repeated. RFA- ablated region diameters ranged from 3.8 to 5.2 cm （median 4.5 cm）. The interval between the salvage surgical resection and RFA was 3-37 months. Before salvage hepatectomy, 23 stage I tumors, 12 stage II tumors, and 32 stage III tumors were present （size ranged 4.83-11.84 cm; median 6.3 cm）. For salvage hepatectomy, laparotomy was performed for 56 cases, and laparoscopy was performed for 28 cases. Inflow clamping was performed for 39 cases （15-45 rain）. Surgery was 219-370 rain and intraoperative blood loss was 100-2100 mL. For 13 cases, intraoperative blood transfusion was required. Tumor pathological data revealed 31,35, and 1 poorly, moderately, and well differentiated tumors, respectively. No patients died due to operative complications, and hospital stays were 8-10 days. Overall and tumor-free survival rates were 85% and 79% for 1 year, 50% and 20% for 3 years, and 39% and 19% for 5 years, respectively. Kaplan- Meier analysis and Cox regression confirmed that tumor number and size prior to salvage liver cancer were risk factors affecting survival. Conclusion Patients who received RFA to treat early-stage liver cancer with postoperative recurrent stage I tumors have satisfactory outcomes with salvage hepatectomy.展开更多
文摘目的评价体表心电图V1导联查颤动波(f波)振幅对射频消融治疗持续性心房颤动(简称房颤)疗效的预测作用。方法连续选取北京军区总医院心血管疾病研究所2010年3月至2013年12月间持续性房颤患者49例。根据随访结果分为两组:未复发组(33例)和复发组(16例)。根据射频消融术中肺静脉隔离后是否转为房扑(包括左房房扑或右房房扑)分为转为房扑组(10例)和未转为房扑组(39例)。测量接受导管射频消融术治疗持续性房颤患者体表心电图V1导联f波的最大振幅和平均振幅。比较两组患者f波最大振幅和平均振幅,并评价其对房颤复发和转为房扑的预测价值。结果与未复发组比较,复发组V1 f波最大振幅[(0.150±0.519)m V vs.(0.094±0.480)m V]和平均振幅[(0.125±0.50)m V vs.(0.077±0.032)m V]降低,差异有显著统计学意义(P均<0.01)。V1导联f波最大振幅及平均振幅的ROC曲线显示曲线下面积分别为0.77(P=0.002)和0.80(P=0.001)。预测术后复发的V1导联f波最大振幅的界值为0.115 m V,敏感性和特异性分别为75.8%和68.7%;平均振幅为0.094 m V,敏感性和特异性分别为78.8%和68.7%。与转为房扑组比较,未转为房扑组V1 f波平均振幅[(0.139±0.052)m V vs.(0.102±0.047)m V]降低,差异有统计学意义(P<0.05)。V1导联f波平均振幅的ROC曲线显示曲线下面积为0.71(P<0.05)。术中转为房扑平均振幅的界值为0.109 m V,敏感性和特异性分别为60%和61.5%。结论持续性房颤V1导联f波的振幅大小与射频消融术后的复发相关,振幅高者复发的可能性低。
文摘AIM： To analyze the long-term prognosis in a cohort of western cirrhotic patients with single hepatocellular carcinoma treated with ethanol injection.METHODS： One-hundred forty-eight patients with solitan/hepatocellular carcinoma were enrolled. The tumor diameter was lower than 2 cm in 47 patients but larger in the remaining 101 patients. The impact of some pre- treatment clinical and laboratory parameters and of tu- mor recurrence on patients＇ survival was assessed.RESULTS： Among the pre-treatment parameters, only a tumor diameter of less than 2 cm was an independent prognostic factor of survival. The occurrence of new nodules in other liver segments and the neoplastic portal invasion were linked to a poorer prognosis at univariate analysis. Patients with a single hepatocellular carcinoma smaller than 2 cm showed a better 5-year cumulative survival （73.0% vs 47.9%） （P = 0.009）, 3-year local re- currence rate （29.1% vs 51.5%） （P = 0.011）, and 5-year distant intrahepatic recurrence rate （52.g% vs 62.8%） （P = 0.054） compared to patients with a larger tumor. CONCLUSION： The 5-year survival rate of patients with single hepatocellular carcinoma 〈 2 cm undergoing ethanol injection is excellent and comparable to that achieved using radiofrequency ablation.
基金Supported by the grant of Ministry of Science and Technology of the People' s Republic of China(2008ZX10002-25)National Natural Science Foundation of China(81070359)
文摘Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods:From January 2009 to November 2011,a series of sixty-one patients were included in the study according to the criteria:each patient had one recurrent HCC,less than 5 cm in diameter.Twenty-six of the 61 patients were treated with PRFA and the other 35 were treated with repeat hepatectomy.Results:The interval from first surgery to recurrent for repeat hepatectomy and PRFA groups were(1,239.60±1,017.00) d and(903.42±975.11) d respectively(P=0.066).The tumor-free time after repeat hepatectomy and PRFA were(310.23±159.50) d and(278.27±123.29) d respectively(P=0.584).Size of tumor in repeat hepatectomy and PRFA were(7.34±3.16) cm^2 and(5.59±3.40) cm^2(P=0.215),the total expenditure for each patient of the two groups were(26,150.66±7,923.60) yuan and(21,135.00±1,156.76) yuan(RMB),and the time of hospitalization for each of the two groups were(15.29±4.28) d and(7.46±2.20) d(P<0.001).Conclusion:PRFA is proved to be as effective as repeat hepatectomy in the treatment of recurrent small HCC,and superior to repeat hepatectomy as it is less invasive.
文摘Objective We studied the efficacy of salvage hepatectomy for treating recurrent hepatic cancer after radiofrequency ablation （RFA）. Methods A retrospective analysis of 67 patients who had recurrent liver cancer after RFA treatment and received salvage hepatectomy in the Department of Hepatobiliary Surgery, Southwest Hospital, Third Mili- tary Medical University （China）, from January 2006 to January 2014, was performed. The analysis included patient gender, age, hepatitis type, alpha-fetoprotein （AFP）, and TNM stage prior to RFA and salvage hepatectomy, overall survival rates, and tumor-free survival rates after salvage hepatectomy. Results Among the 67 patients, there were 57 cases of hepatitis B, two cases of hepatitis C, and eight cases did not have hepatitis. AFP levels in patients ranged from 3 to 4521 ng/mL （median 33 ng/mL）. Before RFA, 54 cases were stage I tumors, and 13 were stage II tumors. Tumor sizes varied from 0.82 to 4.83 cm （median 3.0 cm）. In 20 cases, one RFA was performed, and for 47 cases, RFA was repeated. RFA- ablated region diameters ranged from 3.8 to 5.2 cm （median 4.5 cm）. The interval between the salvage surgical resection and RFA was 3-37 months. Before salvage hepatectomy, 23 stage I tumors, 12 stage II tumors, and 32 stage III tumors were present （size ranged 4.83-11.84 cm; median 6.3 cm）. For salvage hepatectomy, laparotomy was performed for 56 cases, and laparoscopy was performed for 28 cases. Inflow clamping was performed for 39 cases （15-45 rain）. Surgery was 219-370 rain and intraoperative blood loss was 100-2100 mL. For 13 cases, intraoperative blood transfusion was required. Tumor pathological data revealed 31,35, and 1 poorly, moderately, and well differentiated tumors, respectively. No patients died due to operative complications, and hospital stays were 8-10 days. Overall and tumor-free survival rates were 85% and 79% for 1 year, 50% and 20% for 3 years, and 39% and 19% for 5 years, respectively. Kaplan- Meier analysis and Cox regression confirmed that tumor number and size prior to salvage liver cancer were risk factors affecting survival. Conclusion Patients who received RFA to treat early-stage liver cancer with postoperative recurrent stage I tumors have satisfactory outcomes with salvage hepatectomy.
