CAJ | 학술논문

目的：观察超声造影(CEUS)在腹腔镜射频消融(LURFA)治疗原发性肝癌中的临床效果。方法选取2012年1月~2014年10月在我院接受原发性肝癌治疗的患者45例,按随机数字表法分为观察组(D组,超声造影+腹腔镜射频消融)25例,对照组(C组,腹腔镜射频消融)20例。比较两组患者术后消融率及术后并发症(发热、出血、疼痛等)的发生情况,术后1个月通过CEUS对手术疗效进行评价。随访术后6个月患者肿瘤无进展生存率及复发情况。结果 D组术中射频消融的肿瘤直径为(2.92±0.89)cm,较术前超声直径[(2.21±0.32)cm]增大(P<0.05),C组射频消融肿瘤直径与术前比较,差异无统计学意义(P>0.05)；术后1个月复查增强CT扫描,D组术前肿瘤76个,原位灭活或稳定68个(消融率89.4豫),C组术前肿瘤59个,原位灭活或稳定40个(消融率67.8豫),C组消融率较D组升高(P<0.05)；术后6个月复查CT,D组肿瘤无进展生存率为78.9豫,C组为59.3豫,D组高于C组(P<0.05)。术后两组均有发热、出血、疼痛等并发症,无肝衰竭等并发症,并发症发生率比较差异无统计学意义(P>0.05)。结论超声造影在腹腔镜射频消融治疗原发性肝癌中,能够提高肿瘤消融率及术后6个月的肿瘤无进展生存率,且不增加术后并发症,值得临床推广。
목적：관찰초성조영(CEUS)재복강경사빈소융(LURFA)치료원발성간암중적림상효과。방법선취2012년1월~2014년10월재아원접수원발성간암치료적환자45례,안수궤수자표법분위관찰조(D조,초성조영+복강경사빈소융)25례,대조조(C조,복강경사빈소융)20례。비교량조환자술후소융솔급술후병발증(발열、출혈、동통등)적발생정황,술후1개월통과CEUS대수술료효진행평개。수방술후6개월환자종류무진전생존솔급복발정황。결과 D조술중사빈소융적종류직경위(2.92±0.89)cm,교술전초성직경[(2.21±0.32)cm]증대(P<0.05),C조사빈소융종류직경여술전비교,차이무통계학의의(P>0.05)；술후1개월복사증강CT소묘,D조술전종류76개,원위멸활혹은정68개(소융솔89.4예),C조술전종류59개,원위멸활혹은정40개(소융솔67.8예),C조소융솔교D조승고(P<0.05)；술후6개월복사CT,D조종류무진전생존솔위78.9예,C조위59.3예,D조고우C조(P<0.05)。술후량조균유발열、출혈、동통등병발증,무간쇠갈등병발증,병발증발생솔비교차이무통계학의의(P>0.05)。결론초성조영재복강경사빈소융치료원발성간암중,능구제고종류소융솔급술후6개월적종류무진전생존솔,차불증가술후병발증,치득림상추엄。
Objective To observe the clinical effect of contrast-enhanced ultrasonography (CEUS) in laparoscopic ra-diofrequency ablation (LURFA) in treatment of primary liver cancer. Methods 45 patients with primary liver cancer re-ceived therapy from January 2012 to October 2014 of our hospital.Patients were randomly divided into observation group (D group,CEUS and LURFA) (n=25) and control group (C group,LURFA) (n=20) according to random number table.Ablation rateand complications such as fever,bleeding and pain of postoperation were compared between two groups.CEUS was reviewed for efficacy evaluation after 1 month of operation.Progression free survivalcondition of pa-tients was followed-up. Results Tumor diameter of ablation in D group was (2.92±0.89) cm,which was significantly big-ger than that of (2.21±0.32) cm before operation (P<0.05).Tumor diameter of ablation in C group had no significant dif-ference compared with preoperation (P>0.05).Enhanced CT scans reviewed after 1 month of operation,there was 76 tu-mors in D group before operation,68 in situ inactivated or stability (ablation rate was 89.4%).59 tumors in C group be-fore operation,40 in situ inactivated or stability (ablation rate was 67.8%),and the ablation rate was higher in D group (P<0.05).6 months after operation,progression free survival rate in D group was 78.9%,which was significantly higher than that of 59.3% in C group (P<0.05).Complications such as fever,bleeding and pain were all appeared between two groups.There was no complication such as liver failure between two groups,and the incidence rate had no statistical dif-ference (P>0.05). Conclusion CEUS in LURFA in treatment of primary liver cancer can improve ablation rate of tumor, progression free survival rate after 6 months of operation and not increase complications.It is worth popularizing in clin-ical.