肝动脉化疗栓塞联合超声引导下射频消融治疗乏血供大肝癌的临床效果
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摘要
目的探讨肝动脉化疗栓塞(TACE)联合超声引导下射频消融(RFA)治疗乏血供大肝癌的临床效果。方法选取2013年5月～2016年5月我院收治的68例乏血供大肝癌患者,采用随机数字表法将其分为实验组和参照组,每组各34例。参照组患者采取单纯TACE术治疗,实验组患者则在TACE术后进行超声引导下RFA治疗。观察两组患者的临床治疗效果和并发症情况,并随访比较两组术后1、2年内的生存率。结果实验组患者的总有效率为85.29%,高于参照组的73.53%,差异有统计学意义(P<0.05)。两组患者的并发症发生率比较,差异无统计学意义(P>0.05)。实验组患者术后1、2年内的生存率分别为76.47%、47.06%,参照组术后1、2年内的生存率分别为52.94%、26.47%,实验组的生存率高于参照组,差异有统计学意义(P<0.05)。结论 TACE联合超声引导下RFA治疗乏血供大肝癌具有显著的临床效果,能有效延长患者的生存时间,且安全性良好,值得临床推广应用。
Objective To investigate the clinical effect of trans-catheter arterial chemoembolization(TACE) combined with ultrasound-guided radiofrequency ablation(RFA) in the treatment of large hepatocellular carcinoma with lack of blood supply. Methods Altogether 68 patients with large hepatocellular carcinoma with lack of blood supply who were treated in our hospital from May 2013 to May 2016 were selected and divided into the experiment group and the control group by random number table method, with 34 patients in each group. The control group was treated with simple trans-catheter arterial chemoembolization, while the experiment group was treated with ultrasound-guided radiofrequency ablation after TACE. The clinical effects and complications of the two groups were observed, and the survival rates of the two groups within one and two years after operation were followed up and compared. Results The total effective rate of the experiment group was 85.29%, which was higher than that of the control group(73.53%), with statistically significant difference(P<0.05). There was no statistically significant difference in the incidence rate of complications between the two groups(P>0.05). The post-operative 1-year and 2-year survival rates of the experiment group were 76.47% and 47.06% respectively, which were higher than those of the control group(52.94% and 26.47%), with statistically significant difference(P<0.05). Conclusion TACE combined with ultrasound-guided RFA has a significant clinical effect in the treatment of large hepatocellular carcinoma with lack of blood supply, which can effectively prolong the survival time of patients with good safety, and it is worthy of clinical promotion and application.
Objective To investigate the clinical effect of trans-catheter arterial chemoembolization(TACE) combined with ultrasound-guided radiofrequency ablation(RFA) in the treatment of large hepatocellular carcinoma with lack of blood supply. Methods Altogether 68 patients with large hepatocellular carcinoma with lack of blood supply who were treated in our hospital from May 2013 to May 2016 were selected and divided into the experiment group and the control group by random number table method, with 34 patients in each group. The control group was treated with simple trans-catheter arterial chemoembolization, while the experiment group was treated with ultrasound-guided radiofrequency ablation after TACE. The clinical effects and complications of the two groups were observed, and the survival rates of the two groups within one and two years after operation were followed up and compared. Results The total effective rate of the experiment group was 85.29%, which was higher than that of the control group(73.53%), with statistically significant difference(P<0.05). There was no statistically significant difference in the incidence rate of complications between the two groups(P>0.05). The post-operative 1-year and 2-year survival rates of the experiment group were 76.47% and 47.06% respectively, which were higher than those of the control group(52.94% and 26.47%), with statistically significant difference(P<0.05). Conclusion TACE combined with ultrasound-guided RFA has a significant clinical effect in the treatment of large hepatocellular carcinoma with lack of blood supply, which can effectively prolong the survival time of patients with good safety, and it is worthy of clinical promotion and application.
引文
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[10]郭兴军,郑艳红,关强,等.肝动脉化疗栓塞联合射频消融术治疗原发性肝癌的疗效分析[J].实用临床医药杂志,2015,19(5):44-47.
[11]匡远黎,王郑,杨志亮,等.经肝动脉化疗栓塞联合射频消融术对中晚期原发性肝癌的近期疗效分析[J].肝胆胰外科杂志,2017,29(5):363-367.
[12]徐智锋,潘江华,胡逸人,等.肝动脉化疗栓塞联合腹腔镜微波消融治疗大肝癌的临床疗效[J].温州医科大学学报,2017,15(11):810-814.
[13]黄浩,赵现伟,谢斌.超声引导射频消融术治疗肝癌的疗效及对患者免疫功能、肝功能的影响[J].临床和实验医学杂志,2017,16(9):892-895.
[14]李柱,乔安意,王翀,等.超声引导下射频消融术治疗肝癌疗效及预后影响因素分析[J].中国医学物理学杂志,2017,34(10):1058-1063.
[15]徐璐,杜临安.肝动脉化疗栓塞联合射频消融治疗乏血供大肝癌的疗效分析[J].安徽医药,2015,19(6):1111-1114.
[2]独晓勤.肝动脉化疗栓塞联合射频消融术治疗原发大肝癌的疗效分析[J].临床医学研究与实践,2017,2(25):15-16.
[3]张燕如,徐栋,邢培华.肝癌患者应用超声引导下腹腔镜射频消融治疗对其免疫功能的影响分析[J].浙江创伤外科,2016,21(5):961-962.
[4]张志红.肝动脉化疗栓塞联合射频消融术治疗原发性大肝癌30例[J].医药导报,2017,36(A01):19-20.
[5]李新.超声联合腹腔镜射频消融术对肝癌患者肝功能及免疫功能的影响[J].海南医学院学报,2016,22(24):3046-3048.
[6]张英,邓俊,周颜,等.栓塞微球应用于肝动脉化疗栓塞治疗乏血供肝癌的临床观察[J].中国肿瘤临床与康复,2017,20(5):533-536.
[7]中国抗癌协会肝癌专业委员会.原发性肝癌诊断标准[J].中华肝脏病杂志,2000,8(3):135.
[8]王新亭,张传雷,陈晓琦,等.微波消融联合肝动脉插管化疗栓塞术与手术切除巴塞罗那B期原发性肝癌的临床疗效分析[J].中国当代医药,2016,23(34):69-71.
[9]彭卫军,蒋寒,杨雯,等.肝动脉化疗栓塞联合超声引导下射频消融及经皮肝穿刺瘤内无水酒精注射治疗乏血供大肝癌的疗效分析[J].临床医学工程,2018,19(1):11-12.
[10]郭兴军,郑艳红,关强,等.肝动脉化疗栓塞联合射频消融术治疗原发性肝癌的疗效分析[J].实用临床医药杂志,2015,19(5):44-47.
[11]匡远黎,王郑,杨志亮,等.经肝动脉化疗栓塞联合射频消融术对中晚期原发性肝癌的近期疗效分析[J].肝胆胰外科杂志,2017,29(5):363-367.
[12]徐智锋,潘江华,胡逸人,等.肝动脉化疗栓塞联合腹腔镜微波消融治疗大肝癌的临床疗效[J].温州医科大学学报,2017,15(11):810-814.
[13]黄浩,赵现伟,谢斌.超声引导射频消融术治疗肝癌的疗效及对患者免疫功能、肝功能的影响[J].临床和实验医学杂志,2017,16(9):892-895.
[14]李柱,乔安意,王翀,等.超声引导下射频消融术治疗肝癌疗效及预后影响因素分析[J].中国医学物理学杂志,2017,34(10):1058-1063.
[15]徐璐,杜临安.肝动脉化疗栓塞联合射频消融治疗乏血供大肝癌的疗效分析[J].安徽医药,2015,19(6):1111-1114.