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目的:研究经皮微波固化治疗肝内大血管旁复发性肝癌的疗效和安全性。方法:选择2011年2月~2015年12月在我院进行诊治的不能进行手术切除的肝内大血管(肝静脉、肝后下腔静脉、肝动脉或门静脉)旁复发性肝癌患者80例,随机分为观察组和对照组,观察组进行经皮微波固化治疗,对照组进行手术再切除,于治疗前后检查甲胎蛋白、B超,观察术后并发症的发生情况。结果:观察组治疗后甲胎蛋白转阴16例,降低21例,总有效率为92.5%,明显高于对照组的85.9%(P<0.05);治疗后3个月经超声检测肿瘤大小,观察组有15例肿瘤停止生长,21例肿瘤缩小,无效的4例中肿瘤合并肝内转移或出现范围扩大,对照组有14例肿瘤停止生长,19例肿瘤缩小,7例无效,观察组控制肿瘤大小有效率明显大于对照组(P<0.05);观察组并发症发生率为22.5%(9/40),明显低于对照组的35.0%(14/40)(P<0.05)。结论:经皮微波固化治疗肝静脉、肝后下腔静脉、肝动脉或门静脉旁复发性肝癌疗效确切,术后并发症少,可用于临床肝内大血管旁复发性肝癌患者的治疗。
Objective: To study the efficacy and safety of percutaneous microwave coagulation in the treatment of recurrent hepatocellular carcinoma in the liver. Methods: 80 patients with recurrent hepatocellular carcinoma (HCC) beside the large intrahepatic vessels (hepatic vein, inferior vena cava, hepatic artery or portal vein) who can not be surgically resected in our hospital from February 2011 to December 2015 were enrolled. Randomly divided into observation group and control group. The observation group was treated with percutaneous microwave radiation. The control group was surgically resected. AFP and B ultrasound were observed before and after treatment. The incidence of postoperative complications was observed. Results: In the observation group, after 16 cases of AFP were transferred, 16 cases were reduced, the total effective rate was 92.5%, which was significantly higher than that of the control group (85.9%, P <0.05) In the control group, 14 cases of tumor stopped growing, 19 cases of tumor reduced, and 7 cases of tumor did not. The observation group controlled the tumor (P <0.05). The complication rate in the observation group was 22.5% (9/40), which was significantly lower than that in the control group (35.0%, 14/40) (P <0.05). Conclusion: Percutaneous microwave radiation therapy for hepatic vein, retrohepatic inferior vena cava, hepatic artery or portal vein recurrent hepatocellular carcinoma is effective and has few postoperative complications. It can be used in the treatment of patients with transhepatic major peritrocystic recurrent hepatocellular carcinoma.