中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2009年
11期
885-888
,共4页
彭吉润%朱卫华%张大方%公磊%甘丽云%李澍%金仲田%王福顺%陈雷%朱继业%冷希圣
彭吉潤%硃衛華%張大方%公磊%甘麗雲%李澍%金仲田%王福順%陳雷%硃繼業%冷希聖
팽길윤%주위화%장대방%공뢰%감려운%리주%금중전%왕복순%진뢰%주계업%랭희골
肝肿瘤%化学栓塞%治疗性%微波
肝腫瘤%化學栓塞%治療性%微波
간종류%화학전새%치료성%미파
Liver neoplasms%Chemoembolization,therapentic%Microwave
目的 分析微波消融结合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌的疗效.方法 2004年1月至2008年12月,采用微波消融术治疗原发性肝癌患者63例.所有患者接受超声引导(经皮或经腹)消融治疗,疑有病灶消融不完全或复发者,再次行消融治疗或行TACE治疗.结果 本组63例患者分别接受1～5次消融治疗,共82例次.围手术期死亡2例,手术相关死亡率为3.2%.随访时间为2～54个月.随访患者中22例存活,38例死亡,1例失访.全组患者的中位生存期为19.0个月,其1年、2年和3年的累积生存率分别为63.3%、42.1%、26.5%.分层分析显示:(1)初治患者的中位生存期为20.0个月.(2)早期患者(Ⅰ期和Ⅱ期)患者的生存期要明显长于晚期(Ⅲ期和Ⅳ期)患者.(3)病灶单发且其直径≤3 cm的小肝癌患者1、2、3年的累积生存率分别为93.3%、86.7%和65.0%,均明显高于其他非小肝癌患者.(4)肿瘤复发组患者中,肝内仅有单个复发灶且没有淋巴结和远处转移者9例,其1年、2年和3年生存率分别为100%、88.9%和35.6%,其他14例复发患者的1、2、3年的生存率则分别为21.4%、10.7%和0%(P<0.01).结论 超声引导微波消融结合TACE是治疗肿瘤直径≤3 cm小肝癌患者的较好选择,其疗效与手术治疗效果接近;肿瘤复发患者中仅有单个复发病灶无淋巴结和远处转移者,其生存率要明显高于其他复发组患者.
目的 分析微波消融結閤肝動脈栓塞化療(transcatheter arterial chemoembolization,TACE)治療原髮性肝癌的療效.方法 2004年1月至2008年12月,採用微波消融術治療原髮性肝癌患者63例.所有患者接受超聲引導(經皮或經腹)消融治療,疑有病竈消融不完全或複髮者,再次行消融治療或行TACE治療.結果 本組63例患者分彆接受1～5次消融治療,共82例次.圍手術期死亡2例,手術相關死亡率為3.2%.隨訪時間為2～54箇月.隨訪患者中22例存活,38例死亡,1例失訪.全組患者的中位生存期為19.0箇月,其1年、2年和3年的纍積生存率分彆為63.3%、42.1%、26.5%.分層分析顯示:(1)初治患者的中位生存期為20.0箇月.(2)早期患者(Ⅰ期和Ⅱ期)患者的生存期要明顯長于晚期(Ⅲ期和Ⅳ期)患者.(3)病竈單髮且其直徑≤3 cm的小肝癌患者1、2、3年的纍積生存率分彆為93.3%、86.7%和65.0%,均明顯高于其他非小肝癌患者.(4)腫瘤複髮組患者中,肝內僅有單箇複髮竈且沒有淋巴結和遠處轉移者9例,其1年、2年和3年生存率分彆為100%、88.9%和35.6%,其他14例複髮患者的1、2、3年的生存率則分彆為21.4%、10.7%和0%(P<0.01).結論 超聲引導微波消融結閤TACE是治療腫瘤直徑≤3 cm小肝癌患者的較好選擇,其療效與手術治療效果接近;腫瘤複髮患者中僅有單箇複髮病竈無淋巴結和遠處轉移者,其生存率要明顯高于其他複髮組患者.
목적 분석미파소융결합간동맥전새화료(transcatheter arterial chemoembolization,TACE)치료원발성간암적료효.방법 2004년1월지2008년12월,채용미파소융술치료원발성간암환자63례.소유환자접수초성인도(경피혹경복)소융치료,의유병조소융불완전혹복발자,재차행소융치료혹행TACE치료.결과 본조63례환자분별접수1～5차소융치료,공82례차.위수술기사망2례,수술상관사망솔위3.2%.수방시간위2～54개월.수방환자중22례존활,38례사망,1례실방.전조환자적중위생존기위19.0개월,기1년、2년화3년적루적생존솔분별위63.3%、42.1%、26.5%.분층분석현시:(1)초치환자적중위생존기위20.0개월.(2)조기환자(Ⅰ기화Ⅱ기)환자적생존기요명현장우만기(Ⅲ기화Ⅳ기)환자.(3)병조단발차기직경≤3 cm적소간암환자1、2、3년적루적생존솔분별위93.3%、86.7%화65.0%,균명현고우기타비소간암환자.(4)종류복발조환자중,간내부유단개복발조차몰유림파결화원처전이자9례,기1년、2년화3년생존솔분별위100%、88.9%화35.6%,기타14례복발환자적1、2、3년적생존솔칙분별위21.4%、10.7%화0%(P<0.01).결론 초성인도미파소융결합TACE시치료종류직경≤3 cm소간암환자적교호선택,기료효여수술치료효과접근;종류복발환자중부유단개복발병조무림파결화원처전이자,기생존솔요명현고우기타복발조환자.
Objective To evaluate the therapeutic effect of microwave ablation in combination with TACE for the treatment of primary liver carcinoma (PLC). Methods From Jan. 2004 to Dec. 2008, 63 PLC patients underwent ultrasound-guided microwave ablation (percutaneous or open) under general anesthesia. Repeated microwave ablation or TACE was used when an incompleted ablation or recurrence was found during postoperative regular follow-up. Results These 63 PLC patients have received a total of 82 sessions of microwave ablation procedure (1 to 5 sessions for each patient). There were 2 early postoperative deaths with a procedure-related mortality of 3.2%. At the end of the follow-up, 22 patients were alive and 38 died,and the other one was lost to follow-up. The survival rates in 1,2 and 3 years were 63.3%,42.1% and 26.5%, respectively, with a median survival of 20 months for all patients. The survival for PLC patients with early stage (TNM Ⅰ and Ⅱ) was significantly longer than that of advanced stage (TNM Ⅲ and Ⅳ). The 1,2 and 3 year's cumulative survival rate was 93.3%,86.7% and 65.0% respectively in those 15 cases with only single tumor and the diameter≤3 cm, which were significantly longer than that of other PLC patients. Of 23 patients with recurrence,9 had solitary tumor without lymphnode and distal metastases, for which the survival rates in 1,2 and 3 years were 100%,88.9%, and 35.6%, respectively, whereas in other recurrent patients the survival rates in 1,2 and 3 years were 21.4%, 10.7% and 0%, respectively(P< 0.01). Conclusions Ultrasound-guided microwave ablation in combination with TACE is effective for PLC patients with early stage. In recurrent PLC patients after ablation therapy with solitary tumor and no lymphnode and distal metastases the survival is significantly longer than that of the others.
