经皮穿刺门静脉栓塞术联合射频消融治疗肝恶性肿瘤患者疗效及安全性评价

doi:10.3969/j.issn.1672-5069.2017.01.022

摘要/Abstract

摘要： 目的评估经皮穿刺门静脉栓塞术联合射频消融治疗直径>3 cm的肝恶性肿瘤患者疗效及其安全性。方法选择2011年1月-2013年2月在我院诊治的肝脏恶性肿瘤患者93例【肝细胞癌（HCC）78例,肝转移性癌15例】,分为联合组54例和射频消融组39例;联合组患者接受经皮穿刺门静脉栓塞术联合射频消融治疗,射频消融组仅接受射频消融治疗;比较两组患者术后并发症,并随访3年肝脏局部残留复发率及无瘤生存率。结果联合组术后肝周积血4例（7.41%）、胸腔积液2例（3.70%）、远端胆管扩张1例（1.85%）,并发症发生率为12.96%（7/54）;射频消融组术后肝周积血2例（5.13%）、胸腔积液1例（2.56%）、远端胆管扩张2例（5.13%）,并发症发生率为12.82%（5/39）,两组术后并发症发生率无统计学差异（x²=0.000,P=0.984）;联合组术后1 a、2 a和3 a 局部肿瘤残留复发率分别为0.00%、3.70%和11.11%,射频消融组分别为7.69%、20.51%和35.90%,联合组局部残留复发率显著低于射频消融组（x²=4.292、6.667、8.242,P=0.038、0.010、0.004）;联合组术后1 a、2 a和3 a无瘤生存率分别为72.22%、61.11%和55.56%,射频消融组分别为53.85%、43.60%和38.46%,但两组生存率差异比较无统计学意义（x²=3.340、2.797、2.650,P=0.068、0.094、0.104）。结论相比较于单纯射频消融,经皮穿刺门静脉栓塞术联合射频消融术治疗直径>3 cm肝恶性肿瘤在不增加术后并发症的情况下,显著降低了3年内局部肿瘤残留复发率。

关键词: 肝肿瘤, 经皮穿刺, 门静脉栓塞术, 射频消融, 疗效

Abstract: Objective To evaluate the efficacy and safety of portal vein emb1olization and radiorequency ablation in treating patients with liver cancer （diameter >3 cm）. Methods Ninety-three patients with liver cancer（78 with HCC,and 15 with metastasis） between January 2011 and February 2013 in our hospital were divided into combination group （n=54） and control group （n=39）. The patients in combination group were treated with portal vein embolization and radiorequency ablation,while in the control group were treated with radiorequency ablation. The patients were followed-up for three years. The complications,local tumor residual recurrences and disease-free survivals in the two groups were compared. Results After treatment,there were 4 （7.41%） patients with hepatic subcapsular hematoma,2（3.70%） with hydrothorax,1（1.85%） with dilation of distal common bile duct and the complications rate was 12.96%（7/54） in the combination group,while the hydrothorax,distal bile duct expansion and complications rate in the control group were 2 （5.13%）,1 （2.56%）,2 （5.13%） and 12.82% （5/39）,respectively （the differences between the two groups were not statistically significant （x²=0.000,P=0.984）;In combination group,local tumor recurrence rates at 1 a,2 a and 3 a were 0.00%,3.70% and 11.11%,respectively,while they were 7.69%,20.51% and 35.90%,respectively,in the control group （x²=4.292,6.667,8.242,P=0.038,0.010,0.004）;In combination group,the disease-free survival rates at 1 a,2 a and 3 a were 72.22%, 61.11% and 55.56%,while in the control group,they were 53.85%,43.60% and 38.46%,respectively[the differences were not significant（x²=3.340,2.797,2.650,P=0.068,0.094,0.104）]. Conclusion Percutaneous portal vein embolization and radiorequency ablation in the treatment of patients with liver cancer（diameter>3 cm） might decrease significantly the local tumor recurrence in three years,which warrants further investigation.

Key words: Hepatic neoplasms, Percutaneous portal vein embolisation, Radiofrequency ablation, Outcome

张少伟, 刘德见. 经皮穿刺门静脉栓塞术联合射频消融治疗肝恶性肿瘤患者疗效及安全性评价[J]. 实用肝脏病杂志, 2017, 20(1): 85-88.

Zhang Shaowei, Liu Dejian.. Efficacy and safety of percutaneous portal vein embolization and radiorequency ablation in the treatment of patients with liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(1): 85-88.

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