射频消融与微波消融联合放疗对伴门静脉癌栓原发性肝癌患者的治疗效果比较

摘要/Abstract

摘要： 目的比较射频消融与微波消融联合放疗对伴门静脉癌栓原发性肝癌患者的治疗效果。方法选取2011年1月至2019年1月于宜宾市二医院及华西医院治疗的100例伴门静脉癌栓原发性肝癌患者进行回顾性分析,根据治疗方式的不同将其分为射频消融组、微波消融组各50例,射频消融组患者使用射频消融术联合放疗进行治疗,微波消融组患者使用微波消融术联合放疗进行治疗。统计两组患者消融点数、消融时间,对两组患者γ-谷氨酰转肽酶(γ-GT)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、透明质酸酶(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、T淋巴细胞亚群水平进行检测,对比两组患者治疗效果及不良反应发生情况。结果微波消融组患者消融时间低于射频消融组(P<0.05)。治疗后微波消融组患者γ-GT、ALT、AST、HA、LN、PCⅢ、PT、APTT水平均低于射频消融组,FIB水平高于射频消融组(P<0.05)。治疗后微波消融组患者CD₃⁺、CD₄⁺水平高于射频消融组,CD₈⁺水平低于射频消融组(P<0.05)。微波消融组患者治疗总有效率高于射频消融组(P<0.05),微波消融组患者并发症发生率略低于射频消融组,但两组比较差异无统计学意义(P>0.05)。结论微波消融术联合放疗能够改善伴门静脉癌栓原发性肝癌患者肝功能、凝血功能及免疫功能,减轻患者肝纤维化严重程度,治疗效果显著。

关键词: 射频消融术, 微波消融术, 原发性肝癌, 肝功能

Abstract: Objective To compare the effect of radiofrequency ablation and microwave ablation combined with radiotherapy on primary hepatocellular carcinoma with portal vein tumor thrombus.Methods One hundred patients who had primary hepatocellular carcinoma with portal vein tumor thrombus treated in Yibin secong people's hospital and West China Hospital from November 2016 to November 2017 were randomly divided into a radiofrequency ablation group and a microwave ablation group. The radiofrequency ablation group was treated with radiofrequency ablation combined with radiotherapy, while the microwave ablation group was treated with microwave ablation combined with radiotherapy. The ablation points and time of 2 groups were recorded. The levels of glutamyl transpeptidase (γ-GT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronidase (HA), laminin (LN), type Ⅲ procollagen (PC Ⅲ), fibrinogen (FIB) and T lymphocyte subsets, prothrombin time (PT) and activated partial thromboplastin time (APTT) were detected. The therapeutic effects and adverse reactions were compared. Results The ablation time of microwave ablation group was shorter than that of radiofrequency ablation group (P<0.05). After treatment, the levels of γ-GT, ALT, AST, HA, LN and PC Ⅲ in the microwave ablation group were lower than those in the radiofrequency ablation group, PT and APTT were shorter than those in the radiofrequency ablation group, and the level of FIB was higher than that in the radiofrequency ablation group (P<0.05). After treatment, the levels of CD₃⁺ and CD₄⁺ in the microwave ablation group were higher than those in the radiofrequency ablation group, and the level of CD₈⁺ was lower than that in the radio frequency ablation group (P<0.05). The total effective rate of microwave ablation group was higher than that of radiofrequency ablation group (P<0.05). The complication rate of microwave ablation group was slightly lower than that of radiofrequency ablation group, but there was no significant difference between the 2 groups (P>0.05).Conclusion Microwave ablation combined with radiotherapy can improve the liver function, coagulation function, immune function and liver fibrosis in the patients with primary hepatocellular carcinoma and portal vein tumor thrombus.

Key words: Radiofrequency ablation, Microwave ablation, Primary hepatocellular carcinoma, Liver function

林川, 王秋, 游昕. 射频消融与微波消融联合放疗对伴门静脉癌栓原发性肝癌患者的治疗效果比较[J]. 肝脏, 2021, 26(2): 167-170.

LIN Chuan, WANG Qiu, YOU Xin. A comparative study of radiofrequency ablation and microwave ablation combined with radiotherapy in the treatment of primary hepatocellular carcinoma with portal vein tumor thrombus[J]. Chinese Hepatolgy, 2021, 26(2): 167-170.

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