摘要
目的探究CT引导下经皮微波消融术(MWA)治疗原发性肝癌的疗效及预后。方法选择2013年3月至2016年5月接受救治的118例原发性肝癌患者作为研究对象,根据治疗方案将其分为MWA组(n=65)和腹腔镜手术组(n=53)。比较两组患者手术相关指标及肝功能改变。分析影响原发性肝癌患者3年无瘤生存时间和总生存时间的相关因素。结果MWA组患者手术时间、术中出血量、住院时间和住院总费用均低于腹腔镜手术组,差异有统计学意义(P<0.05)。MWA组患者ALT水平低于腹腔镜手术组,ALB水平高于腹腔镜手术组,差异均有统计学意义(P<0.05)。两组血清AST、TBIL水平比较,差异无统计学意义(P>0.05)。两组患者在肿瘤根治率和复发率方面比较,差异均无统计学意义(P>0.05)。MWA组和腹腔镜手术组无瘤生存时间分别为24.52(95%CI:21.5~27.5)个月和25.42(95%CI:22.1~28.7)个月,差异无统计学意义(P>0.05)。MWA组和腹腔镜手术组总生存时间分别为30.83(95%CI:28.4~33.2)个月和31.2(95%CI:28.5~33.8)个月,差异无统计学意义(P>0.05)。肿瘤数目、血管侵犯均与原发性肝癌患者3a无瘤生存时间密切相关。AFP水平、肿瘤数目和血管侵犯与原发性肝癌患者3年总生存时间密切相关。结论MWA具有手术时间短、创伤小、术后恢复快等优点,疗效及预后与腹腔镜手术相似。
Objective To investigate the efficacy and prognosis of percutaneous microwave ablation(MWA)in the treatment of primary hepatocellular carcinoma(HCC).Methods A total of 118 patients with HCC,who received treatment at authors'hospital during the period from March 2013 to May 2016,were enrolled in the study.According to the therapeutic scheme the patients were divided into MWA group(n=65)and laparoscopic surgery group(n=53).The surgery-related indexes and liver function indexes were compared between the two groups.The factors affecting 3-year tumor-free survival time and total survival time in HCC patients were analyzed.Results In MWA group the time spent for operation,the amount of intraoperative blood loss,the length of stay in hospital and the total cost of hospitalization were lower than those in laparoscopic surgery group,the differences between the two groups were statistically significant(P<0.05).The serum level of ALT in MWA group was lower than that in laparoscopic surgery group and the serum level of ALB in MWA group was higher than that in laparoscopic surgery group,the differences between the two groups were statistically significant(P<0.05).No statistically significant differences in the serum levels of AST and TBIL existed between the two groups(P>0.05).The tumor-free survival time in MWA group and laparoscopic surgery group was 24.52 months(95%CI:21.5-27.5)and 25.42 months(95%CI:22.1-28.7)respectively,the difference between the two groups was not statistically significant(P>0.05).The total survival time in MWA group and laparoscopic surgery group was 30.83 months(95%CI:28.4-33.2)and 31.2 months(95%CI:28.5-33.8)respectively,the difference between the two groups was not statistically significant(P>0.05).The number of tumor lesions and vascular invasion were significantly related to tumor-free survival time in 3a HCC patients.AFP level,the number of tumor lesions,and vascular invasion bore a close relationship to overall survival time in 3a HCC patients.Conclusion For the treatment of HCC,MWA has the adv
作者
刘会永
万象新
符孔
王斌
符萧泓
张昌伟
LIU Huiyong;WAN Xiangxin;FU Kong;WANG Bin;FU Xiaohong;ZHANG Changwei(Department of Radiology,Haikou Municipal Third People's Hospital,Haikou,Hainan Province 571100,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第10期991-995,共5页
Journal of Interventional Radiology
关键词
原发性肝癌
微波消融术
腹腔镜手术
疗效
预后
primary hepatocellular carcinoma
microwave ablation
laparoscopic surgery
curative effect
prognosis
