超声引导下经皮射频消融与微波消融治疗原发性肝细胞癌的比较

发布时间：2018-03-01 13:25

本文关键词： 癌肝细胞超声检查导管消融术微波　出处：《中国医学影像学杂志》2015年08期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下经皮射频消融与微波消融治疗原发性肝癌的临床疗效。资料与方法选择超声引导下消融治疗的92例(116个病灶)原发性肝细胞癌患者,随机分为射频消融组(46例)和微波消融组(46例),分别给予射频消融和微波消融治疗,比较两组患者消融术中消融点数、消融时间、完全消融率、局部肿瘤进展率、术后并发症、术后住院时间、住院费用以及术后1年、2年、3年复发率及无复发生存率。结果两组术中平均消融点数差异无统计学意义(P0.05),微波消融组术中消融时间明显短于射频消融组(P0.01)。两组肿瘤完全消融率和局部肿瘤进展率差异均无统计学意义(P0.05)。两组肿瘤直径3 cm者、肿瘤直径3~5 cm者、近血管肿瘤的完全消融率和局部肿瘤进展率比较,差异均无统计学意义(P0.05)。两组术后发热发生率、肝区疼痛发生率及平均住院时间比较,差异均无统计学意义(P0.05)。微波消融组平均住院费用明显低于射频消融组(P0.01)。两组术后1年、2年、3年累计复发率比较,差异无统计学意义(P0.05)。两组总体无复发生存率以及不同大小肿瘤无复发生存率比较,差异无统计学意义(P0.05)。结论微波消融治疗原发性肝细胞癌的临床疗效及安全性与射频消融相当。射频消融治疗对较小的肿瘤有更好的治疗效果,微波消融治疗对中等或较大的肿瘤及近血管肿瘤具有一定的优势。
[Abstract]:Objective to evaluate the clinical efficacy of ultrasound guided percutaneous radiofrequency ablation (RFA) and microwave ablation in the treatment of primary hepatocellular carcinoma (HCC). The patients were randomly divided into radiofrequency ablation group (n = 46) and microwave ablation group (n = 46). The number of ablation points, ablation time, complete ablation rate, local tumor progression rate and postoperative complications were compared between the two groups. Postoperative hospital stay, Results there was no significant difference in mean ablation points between the two groups (P 0.05). The ablation time in microwave ablation group was significantly shorter than that in radiofrequency ablation group (P 0.01). There was no significant difference in total ablation rate and local tumor progression rate between the two groups (P 0.05). The diameter of the tumor was 3 cm in the two groups. There was no significant difference in the complete ablation rate and the local tumor progression rate between the two groups with a diameter of 3 ~ 5 cm. The incidence of postoperative fever, liver pain and average length of stay were compared between the two groups. The average hospitalization cost of microwave ablation group was significantly lower than that of radiofrequency ablation group (P 0.01). The cumulative recurrence rate was 1 year, 2 years and 3 years after operation in both groups. There was no significant difference between the two groups (P 0.05). The overall recurrence free survival rate and the recurrence free survival rate of different size tumors were compared between the two groups. Conclusion the clinical efficacy and safety of microwave ablation for primary hepatocellular carcinoma is similar to that of radiofrequency ablation. Microwave ablation has some advantages over medium or larger tumors and proximal vascular tumors.
【作者单位】：青岛市中心医院肿瘤介入科;青岛市市立医院超声科;
【分类号】：R445.1;R735.7

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