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超声引导下局部消融治疗危险区域原发性肝癌的效果及安全性分析

王婷 王春妍 刘建勇 周永和 陆伟 李嘉 周莉

王婷, 王春妍, 刘建勇, 等. 超声引导下局部消融治疗危险区域原发性肝癌的效果及安全性分析[J]. 临床肝胆病杂志, 2021, 37(7): 1594-1598. DOI: 10.3969/j.issn.1001-5256.2021.07.023
引用本文: 王婷, 王春妍, 刘建勇, 等. 超声引导下局部消融治疗危险区域原发性肝癌的效果及安全性分析[J]. 临床肝胆病杂志, 2021, 37(7): 1594-1598. DOI: 10.3969/j.issn.1001-5256.2021.07.023
WANG T, WANG CY, LIU JY, et al. Effectiveness and safety of ultrasound-guided ablation in treatment of primary liver cancer in dangerous areas[J]. J Clin Hepatol, 2021, 37(7): 1594-1598. DOI: 10.3969/j.issn.1001-5256.2021.07.023
Citation: WANG T, WANG CY, LIU JY, et al. Effectiveness and safety of ultrasound-guided ablation in treatment of primary liver cancer in dangerous areas[J]. J Clin Hepatol, 2021, 37(7): 1594-1598. DOI: 10.3969/j.issn.1001-5256.2021.07.023

超声引导下局部消融治疗危险区域原发性肝癌的效果及安全性分析

DOI: 10.3969/j.issn.1001-5256.2021.07.023
基金项目: 

天津市卫生健康委科技基金项目 2014KZ009

天津市第二人民医院院所级科研基金项目 YS-0012

详细信息
    通讯作者:

    周莉,jasmine_zhou@126.com

  • 中图分类号: R735.7

Effectiveness and safety of ultrasound-guided ablation in treatment of primary liver cancer in dangerous areas

Funds: 

Health Commission of Tianjin Science and Technology Fund Project 2014KZ009

Tianjin Second People's Hospital Scientific Research Fund Project YS-0012

  • 摘要:   目的  探讨超声引导下经皮局部消融术对危险区域肝癌的治疗效果并评估安全性。  方法  选取2014年1月—2017年9月天津市第二人民医院收治的179例初次行超声引导下消融术治疗的原发性肝癌患者,按肿瘤位置不同分为危险区域组(134例)和非危险区域组(45例),均接受消融治疗。术后对患者肿瘤复发、死亡情况进行随访,无复发或死亡者随访至2019年9月。比较危险区域组和非危险区域组患者消融术后并发症、肿瘤完全缓解情况、肿瘤复发或进展及术后生存情况。符合正态分布的计量资料2组间比较采用两独立样本t检验;非正态分布的计量资料2组间比较采用Mann-Whitney U检验;计数资料2组间比较采用χ2检验。采用Kaplan-Meier法分析肿瘤局部进展率、累积生存率,2组间比较采用log-rank检验。  结果  2组患者基线水平无差异。危险区域组和非危险区域组术后轻度、重度并发症发生率,术后1个月甲胎蛋白(AFP)下降率、复常率差异均无统计学意义(42.5% vs 51.1%、6.0% vs 2.22%、75.0% vs 80.0%和33.9% vs 26.3%,P值均>0.05);术后1个月完全缓解率差异无统计学意义(91.8% vs 93.3%,P=0.990);危险区域组和非危险区域组术后1、2年肿瘤无进展生存率分别为60.7%、63.50%和37.1%、55.0%,中位无进展生存时间分别为18个月和27个月,差异无统计学意义(χ2=0.573,P=0.449);术后1、2年累积生存率分别为96.8%、93.3%和90.3%、87.8%,差异无统计学意义(χ2=0.110,P=0.731)。  结论  超声引导下经皮局部消融术治疗危险区域肝癌可行、安全、有效。

     

  • 图  1  2组患者无进展生存率比较

    图  2  2组患者累积生存率比较

    表  1  2组患者一般资料

    项目 危险区域组(n=134) 非危险区域组(n=45) 统计值 P
    男性(例) 95 37 χ2=2.232 0.135
    年龄(岁) 58.3±10.0 58.3±8.7 t=-0.008 0.994
    肿瘤最大直径(cm) 2.3±0.9 2.5±1.0 t=-1.612 0.109
    CNLC期(例) χ2=1.000 0.597
      Ⅰa期 127 43
      Ⅱb期 7 2
    Child-Pugh A级(例) χ2=0.208 0.649
      A级 114 37
      B级 20 8
    术前AFP(例) χ2=0.305 0.581
      升高 62 19
      正常 70 26
    ALT(U/L) 24(17~36) 23(18~37) Z=-0.003 0.997
    AST(U/L) 27(20~38) 32(22~47) Z=-1.688 0.091
    Alb(g/L) 40.6±6.8 41.2±6.9 t=-0.562 0.575
    TBil(μmol/L) 16.6(11.8~23.2) 18.7(13.4~25.8) Z=-1.535 0.125
    INR 1.10±0.18 1.12±0.19 t=-0.769 0.443
    下载: 导出CSV

    表  2  2组患者术后并发症情况比较

    并发症 危险区域组(n=134) 非危险区域组(n=45) χ2 P
    轻度并发症[(例)%] 57(42.5) 23(51.1) 1.002 0.317
      肝区疼痛 17(12.7) 12(26.7)
      非感染性发热 19(14.2) 5(11.1)
      恶心、呕吐 21(15.7) 6(13.3)
    重度并发症[(例)%] 8(6.0) 1(2.2) 0.453 0.290
      消化道出血 3(2.2) 1(2.2)
      术后感染 5(3.7) -
    下载: 导出CSV
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  • 收稿日期:  2020-11-13
  • 修回日期:  2021-01-27
  • 刊出日期:  2021-07-20
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