CAJ | 학술논문

目的探讨超声引导下经皮射频消融与微波消融治疗原发性肝癌的临床疗效.资料与方法选择超声引导下消融治疗的92例(116个病灶)原发性肝细胞癌患者,随机分为射频消融组(46例)和微波消融组(46例),分别给予射频消融和微波消融治疗,比较两组患者消融术中消融点数、消融时间、完全消融率、局部肿瘤进展率、术后并发症、术后住院时间、住院费用以及术后1年、2年、3年复发率及无复发生存率.结果两组术中平均消融点数差异无统计学意义(P>0.05),微波消融组术中消融时间明显短于射频消融组(P<0.01).两组肿瘤完全消融率和局部肿瘤进展率差异均无统计学意义(P>0.05).两组肿瘤直径<3 cm者、肿瘤直径3~5 cm者、近血管肿瘤的完全消融率和局部肿瘤进展率比较,差异均无统计学意义(P>0.05).两组术后发热发生率、肝区疼痛发生率及平均住院时间比较,差异均无统计学意义(P>0.05).微波消融组平均住院费用明显低于射频消融组(P<0.01).两组术后1年、2年、3年累计复发率比较,差异无统计学意义(P>0.05).两组总体无复发生存率以及不同大小肿瘤无复发生存率比较,差异无统计学意义(P>0.05).结论微波消融治疗原发性肝细胞癌的临床疗效及安全性与射频消融相当.射频消融治疗对较小的肿瘤有更好的治疗效果,微波消融治疗对中等或较大的肿瘤及近血管肿瘤具有一定的优势.
목적 탐토초성인도하경피사빈소융여미파소융치료원발성간암적림상료효.자료여방법 선택초성인도하소융치료적92례(116개병조)원발성간세포암환자,수궤분위사빈소융조(46례)화미파소융조(46례),분별급여사빈소융화미파소융치료,비교량조환자소융술중소융점수、소융시간、완전소융솔、국부종류진전솔、술후병발증、술후주원시간、주원비용이급술후1년、2년、3년복발솔급무복발생존솔.결과 량조술중평균소융점수차이무통계학의의(P>0.05),미파소융조술중소융시간명현단우사빈소융조(P<0.01).량조종류완전소융솔화국부종류진전솔차이균무통계학의의(P>0.05).량조종류직경<3 cm자、종류직경3~5 cm자、근혈관종류적완전소융솔화국부종류진전솔비교,차이균무통계학의의(P>0.05).량조술후발열발생솔、간구동통발생솔급평균주원시간비교,차이균무통계학의의(P>0.05).미파소융조평균주원비용명현저우사빈소융조(P<0.01).량조술후1년、2년、3년루계복발솔비교,차이무통계학의의(P>0.05).량조총체무복발생존솔이급불동대소종류무복발생존솔비교,차이무통계학의의(P>0.05).결론 미파소융치료원발성간세포암적림상료효급안전성여사빈소융상당.사빈소융치료대교소적종류유경호적치료효과,미파소융치료대중등혹교대적종류급근혈관종류구유일정적우세.
Purpose To investigate the clinical efficacy of percutaneous radiofrequency ablation and microwave ablation in the treatment of primary hepatic carcinoma.Materials and Methods Ninety-two patients with primary hepatocellular carcinoma (116 lesions) were randomly divided into 46 cases of radiofrequency ablation group and 46 cases of microwave ablation group, which were treated with radiofrequency ablation and microwave ablation, respectively, the ablation points and ablation time, complete ablation rate, local tumor progression rate, postoperative complications, hospitalization time, hospitalization expenses, recurrence rate and relapse-free survival rate 1 year, 2 years and 3 years after surgery were compared and analyzed.Results There was no significant difference between the two groups in average ablation points (P>0.05), and the ablation time of microwave ablation group was significantly shorter than that of radiofrequency ablation group (P<0.01). There was no significant difference in complete ablation rate and local tumor progression rate between the two groups (P>0.05). The difference of complete ablation rate and local tumor progression rate between the two groups of tumor <3 cm, tumor 3-5 cm and tumor near the vessel were not statistically significant (P>0.05). There were no significant differences in the incidence of fever, pain in liver area and average length of hospitalization between the two groups (P>0.05). The average hospitalization cost of microwave ablation group was significantly lower than that of radiofrequency ablation group (P<0.01). There was no statistically significant difference of the cumulative recurrence rate for 1 year, 2 years, 3 years after surgery between the two groups (P>0.05). There was no significant difference between the two groups in the overall relapse-free survival rate and relapse-free survival rate among tumors with different size of the two groups (P>0.05).Conclusion Using microwave ablation for the treatment of primary hepatocellular carcinoma shows a clinical efficacy and safety as good as radiofrequency ablation. Radiofrequency ablation may have better therapeutic effect for smaller tumors, but microwave ablation may have some advantages for medium or large tumors and tumors located near the vessels.