[1]刘冲,何金瞳,李天,等.水隔离技术对降低肝被膜下肿瘤微波消融术后残存的效果评价 [J].介入放射学杂志,2020,29(03):267-273.
　LIU Chong,HE Jintong,LI Tian,et al.Application of hydrodissection technique in reducing residual tumor tissue of hepatic subcapsular malignancy after microwave ablation and evaluation of its curative effect[J].journal interventional radiology,2020,29(03):267-273.
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水隔离技术对降低肝被膜下肿瘤微波消融术后残存的效果评价

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年03
页码:
267-273
栏目:
非血管介入
出版日期:
2020-04-20

文章信息/Info

Title:
Application of hydrodissection technique in reducing residual tumor tissue of hepatic subcapsular malignancy after microwave ablation and evaluation of its curative effect
作者:
刘冲; 何金瞳; 李天; 隋凯达; 张洲博; 洪铎; 苏洪英; 邵海波
Author(s):
LIU Chong;  HE Jintong;  LI Tian;  SUI Kaida;  ZHANG Zhoubo;  HONG Duo;  SU Hongying;  SHAO Haibo.
Department of Interventional Radiology, First Hospital of China Medical University, Shenyang, Liaoning Province 110001, China
关键词:
【关键词】　肝恶性肿瘤; 微波消融; 水隔离技术
文献标志码:
A
摘要:
【摘要】　目的?探索水隔离技术是否可降低肝被膜下恶性肿瘤行微波消融术（MWA）后肿瘤残存。方法?回顾性分析2015年7月至2019年2月诊断为肝被膜下恶性肿瘤（原发性肝癌或肝转移瘤）并行影像引导下MWA治疗102例患者，共122个肿瘤，根据肿瘤是否行水隔离技术分为水隔离组和对照组，水隔离组为应用注水方法隔离肝脏及邻近结构后行MWA，37例患者47个肿瘤；对照组直接行MWA，65例患者75个肿瘤。比较两组治疗后1个月后影像学检查的肿瘤残存情况，并运用单因素、多因素、Cochran’s and Mantel-Haenszel（CMH）分层分析等方法分析肿瘤残存的影响因素。结果?消融技术成功率100%，水隔离技术成功率97.9%。水隔离组与对照组残存率分别为6.5%、21.3%（P=0.03），单因素分析提示水隔离（P=0.03）、肿瘤大小（P＜0.001）与肿瘤残存相关；logistic回归分析显示水隔离技术可显著降低肿瘤残存率［OR=0.202，95%CI （0.048～0.849），P=0.029］，而肿瘤＞3 cm显著增加肿瘤残存率
［OR=18.449，95%CI（5.242～64.933），P＜0.001］。CMH分层分析显示，相比肝继发恶性肿瘤、术前未行TACE治疗的肿瘤、非膈下（靠近胃肠实质脏器、单纯被膜下）肝被膜下肿瘤，肝脏原发肿瘤［OR=0.123，95%CI（0.015～1.019），P=0.025）］ 、术前行TACE治疗的肿瘤［OR=0.123，95%CI（0.015～1.019），P=0.025］
和膈下肝被膜下肿瘤 ［OR=0.081，95%CI（0.009～0.741），P=0.022］应用水隔离技术降低肿瘤残存率方面的作用更加明显。结论?水隔离技术可显著降低肝被膜下恶性肿瘤MWA术后肿瘤残存率，尤其在原发性肝癌、术前行TACE治疗的肿瘤和膈下肝被膜下肿瘤中作用更为明显。

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备注/Memo

备注/Memo:
（收稿日期：2019-05-13）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2020-04-16