中国实用医刊
中國實用醫刊
중국실용의간
Chinese Journal of Practical Medicine
2015年
22期
76-78
,共3页
胃肠道肝细胞癌%经皮微波消融%无水乙醇注射%肝功能%消融率
胃腸道肝細胞癌%經皮微波消融%無水乙醇註射%肝功能%消融率
위장도간세포암%경피미파소융%무수을순주사%간공능%소융솔
Gastrointestinal tract hepatocellular carcinoma%Percutaneous microwave ablation%Ethanol injection%Liver function%Ablation rate
目的：观察经皮微波消融结合温度监测及无水乙醇注射治疗近胃肠道肝细胞癌的临床疗效。方法选取新郑市人民医院收治的近胃肠道肝细胞癌（肿瘤与胃肠道距离≤5 cm）患者68例（88个肿瘤）作为观察组，取同期收治的近胃肠道肝细胞癌患者60例（81个肿瘤）作为对照组，均在温度监测下行经皮微波消融治疗，观察组于近胃肠道边缘肿瘤组织内注射无水乙醇，对照组不予以处理。记录两组治疗前及治疗后1、3个月血清甲胎蛋白（ AFP）水平变化情况；记录肿瘤消融率和并发症发生率；随访12～17个月，了解两组病死率、复发率及肝内转移率。结果观察组肿瘤完全消融率为91.18％，显著高于对照组的64.71％，观察组治疗1、3个月血清甲胎蛋白（ AFP）水平分别为（158.41±18.33）、（57.59±11.26）μg／L，均显著低于对照组，差异有统计学意义（P＜0．05）。随访12～17个月，观察组病死率和肝内转移率分别为17.71％、13.24％，显著低于对照组的30.0％、28.33％，差异有统计学意义（ P＜0.05）。结论温度监测下经皮微波消融联合无水乙醇注射治疗近胃肠道肝细胞癌，有利于提高肿瘤完全消融率。
目的：觀察經皮微波消融結閤溫度鑑測及無水乙醇註射治療近胃腸道肝細胞癌的臨床療效。方法選取新鄭市人民醫院收治的近胃腸道肝細胞癌（腫瘤與胃腸道距離≤5 cm）患者68例（88箇腫瘤）作為觀察組，取同期收治的近胃腸道肝細胞癌患者60例（81箇腫瘤）作為對照組，均在溫度鑑測下行經皮微波消融治療，觀察組于近胃腸道邊緣腫瘤組織內註射無水乙醇，對照組不予以處理。記錄兩組治療前及治療後1、3箇月血清甲胎蛋白（ AFP）水平變化情況；記錄腫瘤消融率和併髮癥髮生率；隨訪12～17箇月，瞭解兩組病死率、複髮率及肝內轉移率。結果觀察組腫瘤完全消融率為91.18％，顯著高于對照組的64.71％，觀察組治療1、3箇月血清甲胎蛋白（ AFP）水平分彆為（158.41±18.33）、（57.59±11.26）μg／L，均顯著低于對照組，差異有統計學意義（P＜0．05）。隨訪12～17箇月，觀察組病死率和肝內轉移率分彆為17.71％、13.24％，顯著低于對照組的30.0％、28.33％，差異有統計學意義（ P＜0.05）。結論溫度鑑測下經皮微波消融聯閤無水乙醇註射治療近胃腸道肝細胞癌，有利于提高腫瘤完全消融率。
목적：관찰경피미파소융결합온도감측급무수을순주사치료근위장도간세포암적림상료효。방법선취신정시인민의원수치적근위장도간세포암（종류여위장도거리≤5 cm）환자68례（88개종류）작위관찰조，취동기수치적근위장도간세포암환자60례（81개종류）작위대조조，균재온도감측하행경피미파소융치료，관찰조우근위장도변연종류조직내주사무수을순，대조조불여이처리。기록량조치료전급치료후1、3개월혈청갑태단백（ AFP）수평변화정황；기록종류소융솔화병발증발생솔；수방12～17개월，료해량조병사솔、복발솔급간내전이솔。결과관찰조종류완전소융솔위91.18％，현저고우대조조적64.71％，관찰조치료1、3개월혈청갑태단백（ AFP）수평분별위（158.41±18.33）、（57.59±11.26）μg／L，균현저저우대조조，차이유통계학의의（P＜0．05）。수방12～17개월，관찰조병사솔화간내전이솔분별위17.71％、13.24％，현저저우대조조적30.0％、28.33％，차이유통계학의의（ P＜0.05）。결론온도감측하경피미파소융연합무수을순주사치료근위장도간세포암，유리우제고종류완전소융솔。
Objective To observe the clinical efficacy of percutaneous microwave ablation combined with tempera-ture monitoring and ethanol injection on proximal gastrointestinal tract hepatocellular carcinoma.Methods Sixty-eight pa-tients(88 tumors) with proximal gastrointestinal tract hepatocellular carcinoma (cancer and gastrointestinal distance is less than or equal to 5 cm) were selected as the observation group, 60 patients(81 tumors) with proximal gastrointestinal tract hepatocellular carcinoma at the same time were selected as the control group, patients were given percutaneous microwave ablation underwent the temperature monitoring, and patients in observation group were given percutaneous ethanol injection in the tissue near the gastrointestinal edge of intratumoral.The changes of serum alpha fetoprotein ( AFP) level of the two groups were recorded before treatment and 1, 3 months after treatment;and the tumor ablation rate and incidence of compli-cations were recorded.The cases were followed up for 12-17 months, the mortality, recurrence rate and liver metastasis rate of the two groups were recorded.Results In observation group, the complete tumor ablation rate (91.18%) was sig-nificantly higher than that in control group(64.71%) .After 1, 3 months treatment followed up, serum AFP level of obser-vation group was (158.41 ±18.33) g/L, (57.59 ±11.26) g/L respectively, which were significantly lower than those of control group(P<0.05).With 12 to 17 months follow up, the mortality and intrahepatic metastasis rates of observation group was 17.71% and 13.24% respectively, which were significantly lower than those of control group ( 30.00%, 28.33%) , the differences were significant ( P <0.05 ) .Conclusions Percutaneous microwave ablation combined with ethanol injection and temperature monitoring in the treatment of proximal gastrointestinal tract hepatocellular carcinoma is conducive to improving the rate of complete tumor ablation.
