高强度聚焦超声（HIFU）治疗原发性肝癌的疗效及并发症分析

发布时间：2018-05-01 11:36

本文选题：高强度聚焦超声 + 射频消融　；参考：《郑州大学》2016年硕士论文

【摘要】：第一部分高强度聚焦超声与射频消融治疗直径小于5cm肝癌疗效对比研究目的比较两种局部消融疗法治疗直径小于5cm肝癌的疗效。方法收集郑州大学第一附属医院2009.09到2014.09微创治疗直径小于5cm肝癌患者122例,其中经高能聚焦超声(HIFU)治疗57例(HIFU组)、经射频消融(RFA)治疗65例(RFA组),对两组患者临床资料及随访结果进行统计学分析。结果HIFU和RFA治疗直径小于5cm肝癌在1个月肿瘤体积消融有效率(P=0.409)、1个月甲胎蛋白(AFP)水平下降率的比较(P=0.475)无统计学差异;HIFU组治疗后1年、3年总体生存率分别为87.8%、59.4%,RFA组治疗后1年、3年总体生存率分别为93.6%、60.4%,治疗后1年生存率RFA组略优于HIFU组,两组患者总体生存率上无明显统计学差异(Log-Rank检验P=0.558)。结论两种局部消融疗法针对直径小于5cm肝癌的治疗均是有效的;两种局部消融疗法治疗后1年生存率RFA组略优于HIFU组,两组患者总体生存率上无明显统计学差异。第二部分高强度聚焦超声治疗原发性肝癌相关并发症分析及处理目的提高高强度聚焦超声(HIFU)治疗原发性肝癌的安全性。方法回顾分析郑州大学第一附属医院2009年12月至2014年9月收治165例经高强度聚焦超声治疗的原发性肝癌患者的临床资料,统计发生的相关并发症并分析处理措施。结果HIFU治疗原发性肝癌常见的并发症主要包括治疗区皮肤软组织损伤(118/165,71.5%)、肝功能一过性损伤(83/165,50.3%)、术后低热(81/165,49.1%)、自限性胸腔积液(42/165,25.5%)及术区疼痛麻木(33/165,20.0%);严重的并发症主要包括肋骨骨折(2例)、脏器穿孔损伤(1例)、癌灶破裂出血(1例)以及皮肤II(5例)、III(1例)度烧伤;所有并发症积极对症处理后均未引起严重后果。结论高强度聚焦超声治疗原发性肝癌安全性高;高强度聚焦超声治疗原发性肝癌常见的并发症为治疗区皮肤软组织损伤、肝功能一过性损伤及术后低热等。
[Abstract]:Part one: comparison of therapeutic effects of high intensity focused ultrasound (HIFU) and radiofrequency ablation (RFCA) on patients with hepatocellular carcinoma (HCC) smaller than that of 5cm. Methods A total of 122 patients with hepatocellular carcinoma smaller than 5cm in diameter from 2009.09 to 2014.09 in the first affiliated Hospital of Zhengzhou University were collected. High intensity focused ultrasound (HIFU) was used to treat 57 patients with HIFU and 65 patients with RFA were treated by radiofrequency ablation. The clinical data and follow-up results of the two groups were analyzed statistically. Results there was no significant difference between HIFU and RFA in the effective rate of tumor volume ablation in one month after 1 month tumor volume ablation. The decrease rate of AFP level was 0.475. There was no significant difference. The 3-year overall survival rate of HIFU group was 87.8% and 59.4%, respectively. The overall survival rate of 1 year and 3 years after treatment was 93.6% and 60.4%, respectively. The 1-year survival rate of RFA group was slightly better than that of HIFU group. There was no significant difference in overall survival rate between the two groups. Conclusion the two kinds of local ablation therapy are effective for HCC with diameter smaller than 5cm, and the 1-year survival rate of RFA group is slightly better than that of HIFU group, and there is no significant difference in overall survival rate between the two groups. The second part: to improve the safety of high intensity focused ultrasound (HIFU) in the treatment of primary liver cancer (PHC) by high intensity focused ultrasound (HIFU). Methods the clinical data of 165 patients with primary liver cancer treated by high intensity focused ultrasound from December 2009 to September 2014 in the first affiliated Hospital of Zhengzhou University were retrospectively analyzed. Results the common complications of HIFU in the treatment of primary liver cancer mainly included skin and soft tissue injury of 118 / 165 or 71.5%, transient injury of liver function 83 / 165 of 50.3%, postoperative low fever of 81 / 165 / 49.1%, self-limited pleural effusion of 42 / 16525.5a) and pain numbness of operation area with 33165% 20.0% of severe complications. There were 2 cases of rib fracture, 1 case of organ perforation injury, 1 case of rupture and hemorrhage of cancer focus) and 1 case of skin II(5. All complications were treated positively without serious consequences. Conclusion it is safe to treat primary liver cancer with high intensity focused ultrasound, and the common complications of high intensity focused ultrasound in treating primary liver cancer are skin soft tissue injury, transient injury of liver function and postoperative low fever.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.7

【相似文献】