血液抽吸联合射频消融治疗肝血管瘤患者疗效研究*

doi:10.3969/j.issn.1672-5069.2022.05.030

实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (5): 726-729.doi: 10.3969/j.issn.1672-5069.2022.05.030

血液抽吸联合射频消融治疗肝血管瘤患者疗效研究^*

任文妍, 赵森, 庄琰, 杜森, 李秋实

475000 河南省开封市河南大学第一附属医院影像科

收稿日期:2022-05-23 出版日期:2022-09-10 发布日期:2022-09-22
通讯作者: 赵森,E-mail:sanmu963.126.com
作者简介:任文妍,女,36岁,医学硕士,主治医师。主要从事肝血管瘤诊治研究。E-mail:913684459@qq.com
基金资助:
河南省开封市科技发展计划项目(编号:2103015)

Short-term efficacy of intratumor blood aspiration and radiofrequency ablation in the treatment of patients with hepatic hemangioma

Ren Wenyan, Zhao Sen, Zhuang Yan et al.

Department of Radiology, First Affiliated Hospital, Henan University, Kaifeng 475000, Henan Province, China

Received:2022-05-23 Online:2022-09-10 Published:2022-09-22

摘要/Abstract

摘要： 目的观察比较血液抽吸联合射频消融(RFA)与肝动脉插管栓塞(TAE)治疗肝血管瘤(HCH)患者的疗效。方法 2018年10月～2020年10月我科收治的102例HCH患者,其中56例接受TAE治疗,另46例接受血液抽吸联合RFA治疗。随访3个月。结果 TAE组手术时间、术中出血量和住院日分别为(49.2±14.6)min、(13.4±3.7)mL和(3.4±1.6)d,而血液抽吸联合RFA治疗组分别为(57.5±18.9)min、(7.5±1.9)mL和(1.5±0.5)d,差异显著(P＜0.05);在术后即刻和术后3个月,TAE治疗组瘤体容积分别为(49.2±22.5)mL和(31.4±15.7)mL,与RFA治疗的(49.1±22.3)mL和(31.2±15.5)mL比,无显著性差异(P>0.05),两组瘤体缩小率比较,也无显著性差异(P>0.05);术后,TAE组并发症发生率为17.9%,显著高于血液抽吸联合RFA治疗组的6.5%(P＜0.05)。结论采用血液抽吸联合RFA治疗HCH患者能够减少术中出血和术后并发症的发生,但两组方法治疗效果相当。

关键词: 肝血管瘤, 肝动脉插管栓塞, 射频消融, 血液抽吸, 治疗

Abstract: Objective The purpose of this study was to compare the short-term efficacy of intratumor blood aspiration and radiofrequency ablation (RFA), and transcatheter arterial embolization (TAE) in the treatment of patients with hepatic hemangioma (HCH). Methods 102 patients with HCH were encountered in our hospital between October 2018 and October 2020, and the RFA after intratumor blood aspiration was conducted in 46 patients and the TAE was performed in 56 patients. All patients were followed-up for three months. Results The operative time, intraoperative blood loss and hospital stay in patients with TAE operation were (49.2±14.6) min, (13.4±3.7) mL and (3.4±1.6) days, significantly different compared to (57.5±18.9)min, (7.5±1.9)mL and (1.5±0.5)days, respectively, in patients receiving RFA after intratumor blood aspiration (P＜0.05); at the moment immediately after operation and the end of three months, the tumor volumes in TAE-treated patients were (49.2±22.5) mL and (31.4±15.7) mL, not significantly different as compared to (49.1±22.3)mL and (31.2±15.5)mL in RFA-treated patients (P>0.05), and so were the tumor shrinkage rates in the two groups (P>0.05); after operation, the complications in TAE-treated patients was 17.9%, much higher than 6.5%(P＜0.05) in RFA-treated patients. Conclusion The short-term efficacy of RFA after intratumor blood aspiration or TAE in the treatment of patients with HCH is good, and the RFA treatment has less post-operationally complications.

Key words: Hepatic hemangioma, Transcatheter arterial embolization, Radiofrequency ablation, Blood aspiration, Therapy

任文妍, 赵森, 庄琰, 杜森, 李秋实. 血液抽吸联合射频消融治疗肝血管瘤患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 726-729.

Ren Wenyan, Zhao Sen, Zhuang Yan et al.. Short-term efficacy of intratumor blood aspiration and radiofrequency ablation in the treatment of patients with hepatic hemangioma[J]. Journal of Practical Hepatology, 2022, 25(5): 726-729.

参考文献

[1]Turkyilmaz G , Sivrikoz T S , Kalelioglu I , et al. Prenatal diagnosis of fetal liver hemangioma. Ultrasound Obst Gyn, 2016, 48(1):306-307.
[2]Duan J . Microimaging for different degrees of human cavernous hemangioma of liver by using in-line phase contrast imaging CT. Med Phys, 2016, 43(6):3679-3680.
[3]Portolani N , Baiocchi G , Gheza F , et al. Impact on liver cancer treatment of a first erroneous diagnosis of hemangioma. World J Surg, 2014, 38(10):2685-2691.
[4]Juan-Carlos A, López-Gutiérrez H. Clinical and economic impact of surgery for treating infantile hemangiomas in the era of propranolol: overview of single-center experience from La Paz hospital, Madrid. Eur J Pediatr, 2018, 178(1):1-6.
[5]王勋, 陈明易, 陈永卫,等. 外科手术治疗肝脏血管瘤908例临床分析. 中华肝胆外科杂志, 2018, 24(7):442-445.
[6]Park S Y , Tak W Y , Jung M K , et al. Symptomatic-enlarging hepatic hemangiomas are effectively treated by percutaneous ultrasonography-guided radiofrequency ablation. J Hepatol, 2011, 54(3):559-565.
[7]Gao J , Ding X , Ke S , et al. Radiofrequency ablation in the treatment of large hepatic hemangiomas: a comparison of multitined and internally cooled electrodes. J Clin Gastroenterol, 2014, 48(6):540-547.
[8]Lyu P , Lin X Z , Li J , et al. Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology, 2011, 259(3):720-729.
[9]Tenkumo C , Hanaoka U , Aboellail M A M , et al. Hdlive flow with hdlive silhouette mode in diagnosis of fetal hepatic hemangioma. Ultrasound Obstet Gynecol, 2017, 49(4):541-542.
[10] Toro A , Mahfouz A E , Ardiri A , et al. What is changing in indications and treatment of hepatic hemangiomas. A review. Ann Hepatol, 2014, 13(4):327-339.
[11] Billio A, Pescosta N, Rosanell C, et al. Treatment of Kasabach-Merritt syndrome by embolisation of a giant liver hemangioma. Am J Hematol,2001,66(2):140-141.
[12] Takahashi H , Akyuz M , Aksoy E , et al. Local recurrence after laparoscopic radiofrequency ablation of malignant liver tumors: results of a contemporary series. J Surg Oncol, 2017, 115(7):830-834.
[13] Federle M P , Brancatelli G , Blachar A . Hepatic hemangioma. N Engl J Med, 2000, 343(5):368-369.
[14] 袁冰, 张金龙, 袁凯,等. 应用博来霉素行超选择性肝动脉栓塞术治疗肝血管瘤. 中华肝胆外科杂志, 2018, 24(8):510-513.
[15] Ypsilantis P , Didilis V , Eleftheriadis S , et al. Early hemodynamic effects after extended liver radiofrequency ablation. Jo Surg Res, 2015, 195(1):204-210.
[16] Goto E , Tateishi R , Shiina S , et al. Hemorrhagic complications of percutaneous radiofrequency ablation for liver tumors. J Clin Gastroenterol, 2010, 44(5):374-380.
[17] 杜英瑞, 柯山, 高君,等.射频消融治疗肝脏良性占位性病变的现状及进展.中华肝胆外科杂志,2018, 24(4):283-286.
[18] 周成明, 张金辉, 任伟新, 等. 514例肝血管瘤的治疗与临床评分. 中华消化外科杂志, 2015, 14(2):102-105.
[19] Hiroyuki MJ, Sugo LY, Yuki S, et al. Hepatic sclerosing hemangioma with predominance of the sclerosed area mimicking a biliary cystadenocarcinoma. Case Rep Hepatol, 2018, 20(1):7353-7357.
[20] 王劭宏, 高君, 柯山,等.射频消融治疗肝脏巨大血管瘤的疗效及安全性.中华普通外科杂志,2014, 29(3):172-176.

血液抽吸联合射频消融治疗肝血管瘤患者疗效研究^*

Short-term efficacy of intratumor blood aspiration and radiofrequency ablation in the treatment of patients with hepatic hemangioma

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	南月敏, 李佳峥. 肝硬化与感染[J]. 实用肝脏病杂志, 2022, 25(5): 609-611.
[2]	罗楠, 李荣宽. 肝硬化并发自发性细菌性腹膜炎诊治现状[J]. 实用肝脏病杂志, 2022, 25(5): 616-619.
[3]	王玉珊, 孔银, 刘元元, 刘天府, 麻爱娣, 张亚萍, 李永芳, 张岭漪. 不同转换治疗策略对经治的低病毒血症慢性乙型肝炎患者疗效的影响:单中心回顾性研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 633-636.
[4]	徐欢, 谭钧元, 黄荷, 董丹丹. 聚乙二醇干扰素α-2a联合恩替卡韦治疗慢性乙型肝炎患者疗效及其外周血单个核细胞TLR4和B7-H1表达变化^*[J]. 实用肝脏病杂志, 2022, 25(5): 637-640.
[5]	王春莹, 屈耀宁, 乔炜, 刘静静, 胡颖辉. 恩替卡韦治疗慢性乙型肝炎患者血清HBV cccDNA和HBV pgRNA水平变化^*[J]. 实用肝脏病杂志, 2022, 25(5): 641-644.
[6]	刘彦彤, 姚杨, 卢博. 荷叶调脂疏肝汤对非酒精性脂肪性肝病患者脂代谢的影响研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 657-660.
[7]	潘飞, 寿涓, 张冬青. 不同他汀类药物治疗非酒精性脂肪性肝病合并高脂血症患者效果分析^*[J]. 实用肝脏病杂志, 2022, 25(5): 665-668.
[8]	李季, 周仲松, 郜玉峰, 薛继华, 张骏飞. 超声融合导航技术指导微波消融治疗小肝癌临床价值研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 698-701.
[9]	张凯, 刘培培, 饶石磊, 王琦, 岳恺, 王旸, 杨峥, 张松. 三维适形放射治疗不同大体肿瘤体积的原发性肝癌患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 710-713.
[10]	李清汉, 甄作均, 何尹韬. 肝动脉化疗栓塞联合射频消融和免疫靶向治疗术后复发的肝细胞癌患者近远期疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 714-717.
[11]	周宇, 耿进朝, 韩雪, 于建华, 回瑾, 李岩, 李微. 射频消融治疗原发性肝癌患者疗效评价^*[J]. 实用肝脏病杂志, 2022, 25(5): 718-721.
[12]	方骏, 王安, 孙修勇, 孙春辉, 张炳远, 朱武晖. 三镜联合分期手术与腹腔镜手术治疗老年胆总管结石合并胆囊结石患者疗效对比研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 730-733.
[13]	迪力旦·纳斯尔, 赵亮, 尼加提江·艾比不拉, 排祖拉·沙拉依阿当. 胆肠Roux-en-Y吻合术留置皮下空肠盲袢治疗肝内胆管结石患者效果分析^*[J]. 实用肝脏病杂志, 2022, 25(5): 734-737.
[14]	郭景龙, 石保昌, 张洪战. 胆肠Roux-en-Y吻合术联合留置皮下空肠盲袢取石治疗肝内胆管结石患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 738-741.
[15]	杜加录, 张凯, 路志宇, 高建华. 完全腹腔镜胆总管囊肿切除术和不同胆道重建术临床效果研究^*[J]. 实用肝脏病杂志, 2022, 25(5): 742-745.