摘要
目的:探索超声引导下改良微波消融治疗原发性肝癌的疗效、免疫功能及对患者血清甲胎蛋白(AFP)和血管内皮生长因子(VEGF)水平的影响。方法:选取医院收治的90例原发性肝癌患者,根据治疗方案的不同将其分为对照组和观察组,每组45例。对照组采用直接瘤体微波消融治疗,观察组采用超声引导下改良微波消融治疗,对比两组疾病控制率(DCR)、并发症发生率,以及各时间段血清指标、免疫指标及VEGF水平。结果:两组T淋巴细胞亚群CD8^(+)、CD4^(+)和自然杀伤(NK)细胞比较差异无统计意义,重复测量方差分析,两组VEGF蛋白值不同时点、交互及组间比较差异有统计学意义(F=8024.415,F=141.449,F=56.377;P<0.05)。两两比较中,观察组治疗后7 d和14 d的谷草转氨酶(AST)、谷丙转氨酶(ALT)、AFP以及VEGF等蛋白值均优于对照组,差异有统计学意义(t_(7 d)=10.229,t=4.579,t=16.077,t=7.197;t_(14 d)=9.916,t=12.118,t=15.499,t=11.947;P<0.05),观察组DCR(91.11%)高于对照组(73.33%),并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.865,χ^(2)=4.406;P<0.05)。结论:对原发性肝癌患者实施超声引导下改良微波消融治疗效果显著,可提高治疗安全性,改善血清AFP、VEGF水平,恢复免疫功能。
Objective:To explore the curative effect and immune function of ultrasound-guided modified microwave ablation in the treatment of primary hepatic carcinoma and the effect of that on the levels of serum alpha fetoprotein(AFP)and vascular endothelial growth factor(VEGF)of patients.Methods:90 patients with primary hepatic carcinoma who admitted to hospital were selected and were divided into control group and observation group according to different treatment schemes,with 45 cases in each group.The control group adopted direct tumor microwave ablation,and the observation group adopted modified microwave ablation under ultrasound guidance.The disease control rate(DCR),occurrence rate of complication,and serum indexes,immune indexes and VEGF levels in each time quantum were compared between the two groups.Results:There were no significant differences in CD8T cells(CD8^(+)),T lymphocyte subsets(CD4^(+))and natural killer(NK)cells between the two groups.The results of repeated measurement variance analysis showed that there were significant differences in VEGF protein values of the two groups among different time points,interaction and comparison among groups(F=8024.415,F=141.449,F=56.377,P<0.05).The results of pairwise comparison indicated that the protein values of aspartate aminotransferase(AST),alanine aminotransferase(ALT),AFP and VEGF at 7th and 14th day after treatment in observation group were significantly better than those in control group,(t_(7d)=10.229,t=4.579,t=16.077,t=7.197,t_(14d)=9.916,t=12.118,t=15.499,t=11.947,P<0.05).DCR rate of observation group(91.11%)was significantly higher than that of control group(73.33%),the difference of that between two groups was statistically significant(χ^(2)=4.865,P<0.05),and the incidence of complications of observation group was significantly lower than that of control group(χ^(2)=4.406,P=0.036).Conclusion:The therapy of ultrasound-guided modified microwave ablation has a significant effect for patients with primary hepatic carcinoma,which can enhance the safety of
作者
巫晓伟
王渝洲
蒋辉
WU Xiao-wei;WANG Yu-zhou;JIANG Hui(Department of Ultrasound,The Second People’s Hospital of Neijiang,Neijiang 641000,China)
出处
《中国医学装备》
2022年第4期101-105,共5页
China Medical Equipment
基金
四川省卫生和计划生育委员会科研课题(17PJ41)“ICG荧光显像联合超声引导消融治疗肝脏肿瘤的临床应用价值”。
