中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
9期
630-633
,共4页
王燕%谢晓燕%徐作峰%吕明德%潘福顺%王伟%郑艳玲%陈立达%林满霞
王燕%謝曉燕%徐作峰%呂明德%潘福順%王偉%鄭豔玲%陳立達%林滿霞
왕연%사효연%서작봉%려명덕%반복순%왕위%정염령%진립체%림만하
肝细胞癌%门静脉癌栓%超声引导%消融%影响因素,预后
肝細胞癌%門靜脈癌栓%超聲引導%消融%影響因素,預後
간세포암%문정맥암전%초성인도%소융%영향인소,예후
Hepatocellular carcinoma%Portal vein embolism%Ultrasound-guide%Ablation%Risk factors,prognosis
目的 探讨超声引导下经皮消融门静脉癌栓(PVTT)的安全性、有效性及预后影响因素.方法 分析超声引导下经皮消融治疗50例患者54个PVTT的并发症、局部疗效及长期生存情况,分析可能影响生存率的因素.结果 50例均顺利完成PVTT消融治疗,发生严重并发症(针道移植)1例(2.0％).局部消融有效率75.9％ (41/54).消融治疗后1、12、24、36个月生存率分别为98.0％、49.7％、28.4％、11.8％.单因素分析显示肝功能Child-Pugh分级(P =0.011)、局部疗效(P=0.015)影响生存率.多因素Cox模型显示局部疗效(P =0.002)、肝功能分级(P =0.018)、年龄(P =0.028)、PVTT消融方法(P =0.049)是影响生存率的因素.结论 超声引导下经皮消融门静脉癌栓是一种较为安全、有效的方法.在经皮消融PVTT中,局部疗效、肝功能分级、年龄、PVTT消融方法是预后影响因素,妥当选择适应证和消融方法是必要的.
目的 探討超聲引導下經皮消融門靜脈癌栓(PVTT)的安全性、有效性及預後影響因素.方法 分析超聲引導下經皮消融治療50例患者54箇PVTT的併髮癥、跼部療效及長期生存情況,分析可能影響生存率的因素.結果 50例均順利完成PVTT消融治療,髮生嚴重併髮癥(針道移植)1例(2.0％).跼部消融有效率75.9％ (41/54).消融治療後1、12、24、36箇月生存率分彆為98.0％、49.7％、28.4％、11.8％.單因素分析顯示肝功能Child-Pugh分級(P =0.011)、跼部療效(P=0.015)影響生存率.多因素Cox模型顯示跼部療效(P =0.002)、肝功能分級(P =0.018)、年齡(P =0.028)、PVTT消融方法(P =0.049)是影響生存率的因素.結論 超聲引導下經皮消融門靜脈癌栓是一種較為安全、有效的方法.在經皮消融PVTT中,跼部療效、肝功能分級、年齡、PVTT消融方法是預後影響因素,妥噹選擇適應證和消融方法是必要的.
목적 탐토초성인도하경피소융문정맥암전(PVTT)적안전성、유효성급예후영향인소.방법 분석초성인도하경피소융치료50례환자54개PVTT적병발증、국부료효급장기생존정황,분석가능영향생존솔적인소.결과 50례균순리완성PVTT소융치료,발생엄중병발증(침도이식)1례(2.0％).국부소융유효솔75.9％ (41/54).소융치료후1、12、24、36개월생존솔분별위98.0％、49.7％、28.4％、11.8％.단인소분석현시간공능Child-Pugh분급(P =0.011)、국부료효(P=0.015)영향생존솔.다인소Cox모형현시국부료효(P =0.002)、간공능분급(P =0.018)、년령(P =0.028)、PVTT소융방법(P =0.049)시영향생존솔적인소.결론 초성인도하경피소융문정맥암전시일충교위안전、유효적방법.재경피소융PVTT중,국부료효、간공능분급、년령、PVTT소융방법시예후영향인소,타당선택괄응증화소융방법시필요적.
Objective To evaluate the efficacy and safety of ultrasound-guided ablation for portal vein tumor thrombus (PVTT) and to investigate the prognostic factors.Methods 50 patients with 54 PVTT underwent percutaneous ultrasound-guided ablation.The local treatment response,overall survival and complications were analysed.Results 50 (100％) patients successfully completed the ablation process.Major complication occurred in 1 patient (2％).41 (75.9％) of 54 thrombi achieved efficacious local therapeutic response.The overall survival rates at 1,12,24 and 36 months were 98.0％,49.7％,28.4％ and 11.8％,respectively.On univariate analysis,liver function grading (P =0.011) and local therapeutic efficacy (P =0.015) were significant predictors of overall survival.On multivariate analysis,local therapeutic efficacy (P =0.002),liver function grading (P =0.018),age (P =0.028) and treatment method of PVTT (P =0.049) were significant predictors of overall survival.Conclusions Percutaneous ultrasound-guided ablation is a safe and efficacious therapeutic technique for PVTT.Prognostic factors of overall survival for PVTT after ablation were regional treatment efficacy,hepatic function grading,age and treatment method of PVTT.It is important to choose a proper treatment method for ablation.
