经皮微波固化对肝内大血管旁复发性肝癌的疗效及安全性

目的:研究经皮微波固化治疗肝内大血管旁复发性肝癌的疗效和安全性。方法:选择2011年2月~2015年12月在我院进行诊治的不能进行手术切除的肝内大血管(肝静脉、肝后下腔静脉、肝动脉或门静脉)旁复发性肝癌患者80例,随机分为观察组和对照组,观察组进行经皮微波固化治疗,对照组进行手术再切除,于治疗前后检查甲胎蛋白、B超,观察术后并发症的发生情况。结果:观察组治疗后甲胎蛋白转阴16例,降低21例,总有效率为92.5%,明显高于对照组的85.9%(P0.05);治疗后3个月经超声检测肿瘤大小,观察组有15例肿瘤停止生长,21例肿瘤缩小,无效的4例中肿瘤合并肝内转移或出现范围扩大,对照组有14例肿瘤停止生长,19例肿瘤缩小,7例无效,观察组控制肿瘤大小有效率明显大于对照组(P0.05);观察组并发症发生率为22.5%(9/40),明显低于对照组的35.0%(14/40)(P0.05)。结论:经皮微波固化治疗肝静脉、肝后下腔静脉、肝动脉或门静脉旁复发性肝癌疗效确切,术后并发症少,可用于临床肝内大血管旁复发性肝癌患者的治疗。

Efficacy and Safety of Percutaneous Microwave Coagulation Therapy on Recurrent Liver Cancer Nearby Great Vessels

Objective:To analyze the efficacy and safety of percutaneous microwave coagulation therapy on the recurrent liver cancer nearby the great vessels.Methods:80 cases of patients with recurrent liver cancer nearby the intrahepatic great vessels (hepatic veins, hepatic arteries and portal vein and inferior vena cava) who were treated in our hospital fromJanuary 2011 to December 2015 were selected and randomly divided into observation group and control group. The patients in observation group received percutaneous microwave coagulation therapy, and the patients in control group underwent remove surgery. AFP, ultrasound were examined before and after the treatment, and the postoperative complications were observed.Results:In observation group after treatment, AFP level was obviously reduced, even turned to negative in some cases and the effective ratewas 92.5%, higher than that of control group (85.9%) with statistical significance (P<0.05). In the observation group after treatment, the tumor stopped growth in 15 cases, and the tumor sizewas reduced in 21 cases, and there were 4 cases with the intrahepatic metastasis tumor or expansion; in control group, the tumor stopped growth in 14 cases, and the tumor size was reduced in 19 cases, and 7 cases were ineffective. The efficacy to control the tumor size in observation group was obviously higher than that of the control group (P<0.05); and the complication rate of observation group was 22.5 % (9/40), significantly lower than 35.0 % of the control group (14/40) (P<0.05).Conclusion:Percutaneous microwave coagulation therapy is safe and effective in the treatment of recurrent liver cancer nearby hepatic veins, hepatic arteries and portal vein and inferior vena cava, so it can be used for clinical treatment of patients with recurrent liver cancer intrahepatic vessels.