CAJ | 학술논문

目的分析超声引导下应用微波消融治疗近胆囊旁肝癌的效果及临床价值。方法选择2009年1月至2012年12月于就诊本科室的近胆囊旁肝癌患者65例为观察组,病灶共65个,选择同期位于肝实质内的肝癌患者50例为对照组,病灶共55个。均行超声引导下微波消融术治疗,统计消融结果。持续随访3~24个月,观察肿瘤的灭活情况及术后并发症。结果两组消融效果均较好,一次消融成功率、辐射时间等均无显著性差异(P>0.05)。观察组术后复查,4个病灶局部肿瘤进展,其发生率6.15%(4/65),疗后3个月,肿瘤完全坏死率89.2%(58/65)；对照组局部肿瘤进展发生率9.09%(5/55),肿瘤完全坏死率94.5%(52/55),两组对比,差异无统计学意义(P>0.05)。随访期间所有患者均未出现明显并发症,仅部分患者出现发热、腹痛等症状,未经特殊处理,自然消退,其中观察组并发症发生率69.23%(45/65),对照组发生率76.00%(38/50),组间差异亦无统计学意义(P<0.05)。结论超声引导微波消融术治疗近胆囊旁肝癌疗效确切,安全性高,具备临床推广价值。
목적분석초성인도하응용미파소융치료근담낭방간암적효과급림상개치。방법선택2009년1월지2012년12월우취진본과실적근담낭방간암환자65례위관찰조,병조공65개,선택동기위우간실질내적간암환자50례위대조조,병조공55개。균행초성인도하미파소융술치료,통계소융결과。지속수방3~24개월,관찰종류적멸활정황급술후병발증。결과량조소융효과균교호,일차소융성공솔、복사시간등균무현저성차이(P>0.05)。관찰조술후복사,4개병조국부종류진전,기발생솔6.15%(4/65),료후3개월,종류완전배사솔89.2%(58/65)；대조조국부종류진전발생솔9.09%(5/55),종류완전배사솔94.5%(52/55),량조대비,차이무통계학의의(P>0.05)。수방기간소유환자균미출현명현병발증,부부분환자출현발열、복통등증상,미경특수처리,자연소퇴,기중관찰조병발증발생솔69.23%(45/65),대조조발생솔76.00%(38/50),조간차이역무통계학의의(P<0.05)。결론초성인도미파소융술치료근담낭방간암료효학절,안전성고,구비림상추엄개치。
Obj ective]To analyze the efficacy and clinical value of ultrasound-guided microwave ablation for liver cancer near to gallbladder.[Methods]A total of 6 5 patients(6 5 lesions)with liver cancer near to gall-bladder in our department from Jan.2009 to Dec.2012 were chosen.Other 50 patients(55 lesions)with liver parenchyma cancer during the same period were chosen as control group.All patients underwent microwave ablation guided by ultrasound.The result of ablation was calculated.All patients were continuously followed up for 3~24 months.The ablation of tumor and postoperative complications were observed.[Results]The ablation effect of two groups was good.There was no significant difference in one-time success rate of ablation and radiation time between two groups(P>0.05).Postoperative reexamination of observation group showed that 4 lesions(6.15%,4/65)were local tumor progression,and the complete tumor necrosis rate at 3 months after treatment was 89.2%(58/65).The rate of local tumor progression in control group was 9.09%(5/55), and the complete tumor necrosis rate was 94.5%(52/55).There was no significant difference in local tumor progression rate and complete tumor necrosis rate between two groups(P>0.05).During the follow-up,no obvious complication occurred in all patients.Only some patients had symptoms such as fever,abdominal pain and so on,and were spontaneous regression without special treatment.The incidence rates of complications in observation group and control group were 69.23%(45/65)and 76.0%(38/50)respectively,but there was no significant difference between two groups(P<0.05).[Conclusion]Ultrasound-guided microwave ablation for the treatment of liver cancer near to gallbladder has certain efficacy,high safety and clinical popularization val-ue.