腹腔镜下微波消融治疗肝恶性肿瘤的效果分析

安东均; 安琳; 张成; 赵维安; 韩立

doi:10.3969/j.issn.1001-5256.2017.11.021

腹腔镜下微波消融治疗肝恶性肿瘤的效果分析

DOI: 10.3969/j.issn.1001-5256.2017.11.021

1. 南方医科大学附属咸阳市中心医院肝胆外科
2. 西安财经学院统计学院
3. 南方医科大学附属咸阳市中心医院超声介入科

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中图分类号: R735.7
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出版历程
- 收稿日期: 2017-06-07
- 出版日期: 2017-11-20

Efficacy of laparoscopic microwave ablation in treatment of malignant liver tumors

Department of Hepatobiliary Surgery, Xianyang Central Hospital, Southern Medical University

摘要

摘要: 目的探讨腹腔镜下微波消融（MWA）治疗肝恶性肿瘤的局部疗效和安全性。方法回顾性分析2014年6月-2016年5月南方医科大学附属咸阳市中心医院采用微波消融治疗的肝恶性肿瘤患者105例。按照MWA的入路分为超声引导下经皮肝穿刺MWA组（A组）55例和腹腔镜下MWA组（B组）50例。采用Kaplan-Meier法计算平均无瘤生存时间。计数资料组间比较比较采用χ2检验,正态分布的计量资料组间比较采用t检验。结果所有患者术后症状均有改善,肝区疼痛明显减轻,食欲增进。A、B组MWA并发症发生率分别为27.3%和8.0%,差异有统计学意义（χ2=6.144,P<0.05）;一次性完全消融率分别为74.5%和92.0%,差异有统计学意义（χ2=5.162,P<0.05）;术后1个月肝功能Child-Pugh分级评价比较差异有统计学意义（χ2=2.135,P<0.05）;平均住院费用B组高于A组,（t=3.612,P<0.05）;2组患者平均住院时间、平均无瘤生存时间及1年无瘤生存率无明显差...
- 肝肿瘤 /
- 导管消融术 /
- 腹腔镜 /
- 治疗结果
Abstract: Objective To investigate the local efficacy and safety of laparoscopic microwave ablation (MWA) in the treatment of malignant liver tumors.Methods A retrospective analysis was performed for the clinical data of 105 patients with malignant liver tumors who were admitted to Xianyang Central Hospital, Southern Medical University, from June 2014 to May 2016 and treated by MWA.According to the surgical approach of MWA, these patients were divided into ultrasound-guided percutaneous microwave coagulation therapy group (group A) with 55 patients and laparoscopic MWA group (group B) with 50 patients.The Kaplan-Meier method was used to calculate mean disease-free survival.As for the data of postoperative complications, local efficacy of MWA, liver function at 1 month after surgery, mean disease-free survival time, and 1-, 2-, and 3-year disease-free survival rates after surgery, the chi-square test was used for the comparison of categorical data between groups;the normally distributed continuous data were expressed as mean±SD, and the t-test was used for comparison.Results All patients had improvements in the symptoms after surgery, marked alleviation of liver pain, and increased appetite.There were significant differences between group A and group B in the incidence rate of complications (27.3% vs 8.0%, χ2=6.144, P<0.05) , one-time complete ablation rate (74.5% vs 92.0%, χ2=5.162, P<0.05) , and Child-Pugh class of liver function at 1 month after surgery (χ2=2.135, P<0.05) .Group B had significantly higher mean hospital costs than group A (t=3.612, P<0.05) .There were no significant differences between the two groups in mean hospital stay, mean disease-free survival time, and 1-year disease-free survival rate (t=0.628, χ2=0.562 and 0.288, all P>0.05) .Compared with group A, group B had significantly higher 2-and 3-year disease-free survival rates (χ2=6.426 and 3.162, both P<0.05) .Conclusion The laparoscopic approach expands and optimizes the range of the indications for microwave therapy for liver tumors and has good efficacy and few complications.
- liver malignant tumors /
- catheter ablation /
- laparoscopes /
- treatment outcome

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参考文献(7)

[1]TIAN WS, KUANG M, LYU MD, et al.A randomised comparative trial on liver tumors treated with ultrasound-guided percutaneous radiofrequency versus microwave ablation[J].Chin J Hepatobiliary Surg, 2014, 20 (2) :119-122. (in Chinese) 田文硕, 匡铭, 吕明德, 等.超声引导经皮射频消融与微波消融治疗肝脏肿瘤的随机对照研究[J].中华肝胆外科杂志, 2014, 20 (2) :119-122.

[2]LIU P, WEI ZB, YU JY, et al.Clinical efficacy of microwave ablation and surgical resection for the treatment of early hepatocellular carcinoma:a Meta analysis[J].Chin J Dig Surg, 2015, 14 (12) :1031-1037. (in Chinese) 刘平, 魏子白, 于俊岩, 等.微波消融与手术切除治疗早期原发性肝癌临床疗效的Meta分析[J].中华消化外科杂志, 2015, 14 (12) :1031-1037.

[3]AN DJ, ZHENG XY, ZHANG C.A clinical study of complications arising from microwave ablation for 358 liver tumors[J].J Hepatobiliary Surg, 2015, 23 (1) :24-26. (in Chinese) 安东均, 郑晓燕, 张成.358例肝肿瘤微波消融并发症的临床分析[J].肝胆外科杂志, 2015, 23 (1) :24-26.

[4]LIU LN, XU HX, LU MD, et al.Percutaneous Ultrasoundguided thermal ablation liver tumor with artificial pleural effusion or ascites[J].Chin J Cancer, 2010, 29 (9) :830-835.

[5]HUANG QS.Chang in immune function after microware ablation for liver cancer[J].Diagn Imag Interv Radiol, 2015, 24 (4) :330-334. (in Chinese) 黄巧胜.肝癌微波消融后的机体免疫功能变化[J].影像诊断与介入放射学, 2015, 24 (4) :330-334.

[6]LI XH, FENG ZQ, ZHANG HY, et al.Severe complications after ultrasound-guided percutaneous microwave coagulation therapy for primary hepatic car-cinoma[J].J Clin Hepatol, 2016, 32 (1) :72-75. (in Chinese) 李新慧, 冯志强, 张洪义, 等.原发性肝癌患者行超声引导下经皮微波消融术后相关并发症的发生情况[J].临床肝胆病杂志, 2016, 32 (1) :72-75.

[7]LIU B, LI WG, CHEN FZ.Laparoscopic hepatectomy:the choice in the era of minimally invasive surgery[J].J Clin Hepatol, 2017, 33 (4) :643-646. (in Chinese) 刘斌, 李文岗, 陈福真.腹腔镜肝切除术---微创外科时代的选择[J].临床肝胆病杂志, 2017, 33 (4) :643-646.

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