摘要
目的对比超声及CT两种引导方式下进行原发性肝癌射频消融(RFA)治疗的手术时间、安全性及临床疗效。方法回顾性分析2009年9月至2014年10月收治的肝细胞肝癌RFA治疗患者158例,其中超声引导下59例;CT引导下99例;统计使用超声/CT引导两种方式进行RFA治疗过程中手术用时的差别、术中不良反应及术后并发症,随访两组患者的局部复发率、无疾病进展时间(PFS)和总生存期(OS)。结果两组患者术后严重不良反应率差异无明显统计学意义(P=0.193,>0.05),安全性相当。超声组平均手术时间(26.03 min)小于CT组平均手术时间(61.78 min),两组差异有显著统计学意义(P<0.0001)。超声组与CT组的局部复发率无统计学差异。超声组的PFS和OS分别为287.0(157.9~416.1 d)和1907.0 d(1281.7~2532.3 d)。CT组的PFS和OS分别为272.0(177.9~366.1)d和1932 d。两者差异均无明显统计学意义。结论原发性肝癌患者在超声和CT引导下均能够完成肝肿瘤的RFA治疗,其中超声引导更加简单快捷,操作时间短,疗效相比CT引导无明显差别。
Objective To compare the time spent for operation,safety and clinical curative effect of ultrasound-guided(US-guided)radiofrequency ablation(RFA)with those of CT-guided RFA in treating hepatocellular carcinoma(HCC).Methods From April 2010 to November 2014,158 admitted patients with HCC received US-guided RFA(US group,n=59)or CT-guided RFA(CT group,n=99).The time spent for RFA procedure,intraoperative adverse reactions and postoperative complications were compared between the two groups.The patients were followed up to observe the local recurrence rate,progression-free survival(PFS)time and overall survival(OS)time.Results There was no significant difference in the occurrence rate of postoperative serious adverse reactions between the two groups(P=0.193).The safety of the two groups was the same.The average time spent for RFA procedure in US group was 26.03 minutes which was obviously lower than 61.78 minutes in CT group,the difference between the two groups was statistically significant(P<0.0001).No statistically significant difference in the local recurrence rate existed between the two groups.The PFS and OS in US group were 287.0 d(157.9-416.1 d)and 1907.0 d(1281.7-2532.3 d)respectively,which were 272.0 d(177.9-366.1 d)and 1932 d respectively in CT group(as the number of deaths in CT group did not exceed 50%,it was not able to estimate the 95%confidence interval).The differences in PFS and OS between the two groups were not statistically significant.Conclusion RFA,regardless of under US guidance or under CT guidance,can be successfully accomplished in HCC patients.US-guided RFA is simpler and quicker,the time spent for procedure is shorter,and its curative effect for HCC is similar to that of CT-guided RFA.
作者
吴林霖
施一翔
刘敬禹
江旭
杨朝爱
杨继金
WU Linlin;SHI Yixiang;LIU Jingyu;JIANG Xu;YANG Chaoai;YANG Jijin(Department of Interventional Radiology,Affiliated Changhai Hospital of Naval Military Medical University,Shanghai 200433,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第12期1162-1166,共5页
Journal of Interventional Radiology
基金
国家临床重点专科军队建设项目(008011001010)
济宁医学院青年教师科研扶持基金(JY2016KJ014)
关键词
射频消融
超声引导
CT引导
原发性肝癌
radiofrequency ablation
ultrasound guidance
CT guidance
hepatocellular carcinoma
