CAJ | 학술논문

目的探讨经皮选择性门静脉栓塞术(SPVE)对提高冷循环射频消融(RFA)治疗直径＞3cm肝恶性肿瘤的疗效及安全性.方法对拟行射频消融的肝恶性肿瘤中为单发病灶,最大径＞3 cm且结节完全或大部分位于一个肝段内的患者63例,以1∶2配对方式随机表法随机入组,21例射频治疗前先行门静脉栓塞术(SPVE+ RFA组),42例患者单纯行射频消融治疗(RFA组),对比分析两组患者术后并发症发生情况、肿瘤消融效果.结果 SPVE+ RFA组中1例SPVE操作失败,其余均操作成功,两组均未发生严重并发症.术后平均随访14.2个月,RFA组术后的局部残留复发率为40.5％(17/42),而SPVE+RFA组的局部残留复发率为15.0％ (3/20),两组差异有统计学意义(P=0.043).结论 SPVE能安全有效地增加单一肝段内＞3 cm肿瘤RFA的疗效.
목적 탐토경피선택성문정맥전새술(SPVE)대제고랭순배사빈소융(RFA)치료직경＞3cm간악성종류적료효급안전성.방법 대의행사빈소융적간악성종류중위단발병조,최대경＞3 cm차결절완전혹대부분위우일개간단내적환자63례,이1∶2배대방식수궤표법수궤입조,21례사빈치료전선행문정맥전새술(SPVE+ RFA조),42례환자단순행사빈소융치료(RFA조),대비분석량조환자술후병발증발생정황、종류소융효과.결과 SPVE+ RFA조중1례SPVE조작실패,기여균조작성공,량조균미발생엄중병발증.술후평균수방14.2개월,RFA조술후적국부잔류복발솔위40.5％(17/42),이SPVE+RFA조적국부잔류복발솔위15.0％ (3/20),량조차이유통계학의의(P=0.043).결론 SPVE능안전유효지증가단일간단내＞3 cm종류RFA적료효.
Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.