摘要
目的观察胆管冷却技术在中央胆管旁肝癌微波消融术中的应用效果。方法回顾性分析2011年1月至2019年1月中南大学湘雅医学院附属肿瘤医院肝胆外科行中央胆管旁肝癌微波消融术治疗的84例患者,随机分为两组,每组42例。对照组未行任何胆管保护措施,观察组行内镜鼻胆管引流术灌注冷却液,比较两组患者的近期疗效、并发症发生率。结果观察组术后1个月内肿瘤完全坏死率明显高于对照组,对照组有肿瘤组织残留率较高,且观察组术后原位复发率、肝癌新发病灶率低于对照组(P<0.05);观察组胆道出血、十二指肠乳头活动性出血、急性胰腺炎、胆汁瘤等并发症发生率明显低于对照组(P<0.05)。结论胆管冷却技术在中央胆管旁肝癌微波消融术中的应用效果显著,能有效保护胆道及周围组织,减少热损伤所致并发症,提升肿瘤清除率,降低复发率及胆管侵犯率。
Objective To investigate the application effect of bile duct cooling technology in microwave ablation of central cholangiocarcinoma.Methods From January 2011 to January 2019,84 patients of hepatobiliary surgery department of our hospital who were treated with microwave ablation of hepatocellular carcinoma adjacent to the central bile duct were randomly divided into two groups,42 cases each.The control group received no bile duct protection measures,and the observation group received endoscopic nasobiliary drainage and perfusion of cooling fluid.The short-term efficacy and complication rate of the two groups were compared.Results The rate of complete tumor necrosis in the observation group was significantly higher than that in the control group within 1 month after surgery,and the residual rate of tumor tissue in the control group was higher,and the rate of in situ recurrence and new liver cancer in the observation group was lower than that in the control group(P<0.05).The incidence of complications such as biliary hemorrhage,duodenal papillary active hemorrhage,acute pancreatitis and cholangioma in the observation group were significantly lower than that in the control group(P<0.05).Conclusion The application of bile duct cooling technology in microwave ablation of hepatocellular carcinoma near the central bile duct is effective,which can effectively protect the bile duct and surrounding tissues,reduce the complications caused by thermal injury,improve the tumor clearance rate,and reduce the recurrence rate and bile duct invasion rate.
作者
黄斌
黄满平
熊正平
李国文
唐田
HUANG Bin;HUANG Manpin;XIONG Zhengping;LI Guowen;TANG Tian(Department of Intervention Radiology,Affiliated Tumor Hospital of Xiangya Medical College,Central South Universitity,Changsha,Hunan 410013,China)
出处
《大医生》
2019年第5期37-38,共2页
Doctor
关键词
中央胆管旁肝癌
微波消融术
胆管冷却技术
应用效果
central cholangiocarcinoma
microwave ablation
bile duct cooling technology
application effect
