实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清Bax、Cyfra21-1的影响

摘要 目的：探讨实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清BCL-2同源的水溶性相关蛋白（Bax）、细胞角蛋白19片段（Cyfra21-1）的影响。方法：选择本院2017年1月到2021年4月收治的原发性肝癌合并门静脉癌栓患者82例作为研究对象，根据1：1随机数字表法将患者分为虚拟导航组与对照组各41例，虚拟导航组给予实时影像融合的超声虚拟导航技术联合射频消融术治疗，对照组给予单纯超声引导联合射频消融术治疗。结果：虚拟导航组的进针次数、融合时间、布针时间少于对照组（P<0.05）；虚拟导航组治疗后3个月的胆汁瘤、肝脓肿、膈肌损伤、肺部感染等并发症发生率为4.9 %，低于对照组的29.3 %（P<0.05）。虚拟导航组治疗后3个月的总有效率为82.9 %，高于对照组的51.2 %（P<0.05）。两组治疗后3个月的血清谷丙转氨酶（ALT）、谷草转氨酶（AST）水平低于治疗前，虚拟导航组低于对照组（P<0.05）。两组治疗后的血清Bax、Cyfra21-1含量低于治疗前，虚拟导航组低于对照组（P<0.05）。结论：实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓能降低血清Bax、Cyfra21-1含量，改善患者的肝功能，提高消融效率，还可减少并发症的发生，最终提高患者的总体治疗效果。

Real-time Image Fusion Ultrasound Virtual Navigation Technology Combined with Radiofrequency Ablation in the Treatment of Patients with Primary Liver Cancer and Portal Vein Tumor Thrombus and Its Effect on Serum Bax and Cyfra21-1

ABSTRACT Objective: To investigate the efficacy of real-time image fusion ultrasound virtual navigation technology combined with radiofrequency ablation in the treatment of patients with hepatocellular carcinoma and portal vein tumor thrombosis and the treatment of serum BCL-2 homologous water-soluble related protein (Bax) and cytokeratin 19 Fragment (Cyfra21-1) influence. Methods: From January 2017 to April 2021, 82 cases of patients with hepatocellular carcinoma combined with portal vein tumor thrombus admitted to our hospital were selected as the research objects. All the patients were divided into virtual navigation group and control group with 41 cases in each groups accorded to the 1:1 random number table method. The virtual navigation group were treated with real-time image fusion ultrasound virtual navigation technology combined with radiofrequency ablation, and the control group were treated with pure ultrasound guidance combined with radiofrequency ablation. Results: The number of needle insertions, fusion time, and needle placement time in the virtual navigation group were less than those in the control group(P<0.05). The incidence of complications such as bileoma, liver abscess, diaphragm injury, and lung infection in the virtual navigation group at 3 months after treatment were 4.9 %, which were lower than 29.3 % in the control group(P<0.05). The total effective rate of the virtual navigation group at 3 months after treatment were 82.9 %, which were higher than 51.2 % in the control group(P<0.05). The levels of serum ALT and AST in the two groups at 3 months after treatment were lower than before treatment, and the virtual navigation group were lower than the control group (P<0.05). The serum Bax and Cyfra21-1 levels after treatment in the two groups at 3 months after treatment were lower than before treatment, and the virtual navigation group were lower than the control group (P<0.05). Conclusion: Real-time image fusion ultrasound virtual navigation technology combined with radiofrequency ablation in the treatment of hepatocellular carcinoma with portal vein tumor thrombus can reduce serum Bax and Cyfra21-1 levels, improve patients'' liver function, increase ablation efficiency, and reduce complications, and ultimately improve the patient''s overall treatment effect.