实时虚拟导航系统辅助超声引导下消融治疗肝癌患者疗效与安全性的系统评价

目的:系统评价实时虚拟导航系统辅助超声引导下射频消融治疗肝癌患者疗效与安全性,为临床治疗提供参考。方法:计算机检索Pubmed、EMbase、The Cochrane Library、Web of Science、WanFang Data、CNKI、CBM、VIP数据库,同时辅以其他检索,收集所有相关的临床对照试验,检索时限从各数据库建库起至2019年12月。由两位评价员分别独立根据纳入与排除标准对文献进行筛选、提取资料及质量评价,后采用RevMan 5.3软件进行分析。结果:共纳入6个队列研究,包括1845例患者。试验组为实时虚拟导航系统(Real-time Virtual Navigation System, RVS)辅助超声引导下(Ultrosound, US)/(Contrast Enhanced Ultrosound, CEUS)消融治疗肝癌组,即RVS+US/CEUS组,对照组为超声引导下消融治疗肝癌组,即US/CEUS组。分析结果显示:在提高肿瘤消融率方面,试验组显著优于对照组(P<0.05),在并发症发生率方面,试验组与对照组结局指标无统计学差异。结论:RVS辅助超声引导下射频消融治疗肝癌患者在提高肿瘤消融率方面优于传统超声引导下射频消融治疗。

Efficacy and Safety of Real-time Virtual Navigation System Assisted Ultrasound-guided Ablation for Hepatocellular Carcinoma : a Systematic Review

ABSTRACT Objective: To evaluate the clinical efficacy and safety of real-time virtual navigation system(RVS) assisted ultrasound(US)-guided ablation for hepatocellular carcinoma, so as to provide references for clinical treatment. Methods: We electronically searched databases including Pubmed, Embase, The Cochrane Library, Web of Science, WanFang Data, CNKI, CBM, VIP from inception to December 31st, 2019, for the all relevant clinical controlled trails. Other sources were also retrieved. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. Then, review was performed using RevMan 5.3 software. Results:: A Total of 6 clinical controlled trails involving 1845 patients were included. The trial group was given real-time virtual navigation system(RVS) assisted ultrasound-guided ablation, including ultrosound(US) and contrast enhanced ultrosound(CEUS), for hepatocellular carcinoma, that was RVS+US/CEUS group, while the controlled group was given ultrasound-guided ablation for hepatocellular carcinoma alone, that was US/CEUS group. The results of the review showed that, the trail group was significantly superior to the controlled group in improving the rates of tumor ablation (P<0.05). There were also no statistical differences between the two groups in the rate of complacations. Conclusion: The efficacy of RVS assisted US-guided ablation for hepatocellular carcinoma is higher than traditional US-guided ablation.