[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