| 摘要: |
| 目的 探讨实时超声造影(Contrast-enhanced ultrasound,CEUS)引导下单极射频消融(Monopolar Radiofrequency Ablation,M-RFA)与无接触多极射频消融(No-touch Multipolar Radiofrequency Ablation,No-touch RFA)治疗肝肿瘤的临床应用价值。方法 本研究回顾性分析自2015年2月至2017年5月,在我院行实时CEUS引导下M-RFA 及No-touch RFA两种方法治疗肝肿瘤患者94例(M-RFA方法44例,No-touch RFA方法50例),分析术后病灶灭活范围、灭活率、并发症,比较治疗前、后肝功能、AFP、CEUS、增强CT、MRI情况,并定期随访24个月,观察患者的无瘤生存率。结果 RFA治疗后,CEUS测量消融灭活范围平均值：M-RFA组为38.36x31.31mm,No-touch RFA组为46.70x35.82mm；完全灭活率：M-RFA组90.9%(40/44),No-touch RFA组98.00%(49/50),差异具有统计学意义(P＜0.05)。治疗术后1～6个月,M-RFA组21例甲胎蛋白(AFP)阳性的患者,8例明显下降,12例转阴；No-touch RFA组20例AFP阳性的患者,5例明显下降,14例转阴,两组AFP水平,术前术后比较,差异具有统计学意义(P＜0.05)；术后规律随访至24个月,无瘤生存率：M-RFA组47.72%(21/44),No-touch RFA组68.00%(34/50),差异具有统计学意义(P＜0.05)。结论 实时CEUS引导下No-touch RFA治疗肝肿瘤,有助于提高肿瘤的灭活率,疗效显著,无瘤生存率高,具有重要应用价值。 |
| 关键词: 超声造影 射频消融 肝肿瘤 |
| DOI： |
| 投稿时间：2019-10-30修订日期：2019-10-30 |
| 基金项目:超声造影定量分析仪的研发(cstc2016shmszx130080) |
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| Comparison of the application value of Monopolar Radiofrequency Ablation and No-Touch Multipolar Radiofrequency Ablation in the treatment of liver tumors under the guidance of contrast-enhanced ultrasound |
| chenping,guoyanli |
| (First Affiliated Hospital of Army Medical University) |
| Abstract: |
| ABSTRACT Objective To investigate the clinical value of real-time contrast-enhanced ultrasound guided monopolar radiofrequency ablation (M-RFA) and no-touch multipole radiofrequency ablation (No-touch RFA) in the treatment of liver tumors. Methods This study retrospectively analyzed 94 cases of liver tumors patients (including M-RFA methods 44 cases, No-touch RFA methods 50 cases) treated with M-RFA and no-touch RFA under the guidance of real-time CEUS in our hospital from February 2015 to May 2017. Postoperative lesion inactivation range, inactivation rate and complications were analyzed,and liver function,AFP, CEUS,enhanced CT and MRI before and after treatment were compared, and patients were followed up regularly for 24 months,the disease-free survival rate was followed. Results After RFA treatment, CEUS was used to measure the inactivation range. The average inactivation range of the M-RFA group and the No-touch RFA group was 38.36x31.31mm and 46.70x35.82mm, respectively. The total tumor necrosis rate was: 90.9% (40/44) and 98.00% (49/50), respectively, in the M-RFA group and the No-touch RFA group，the difference was statistically significant (P<0.05).In the M-RFA group, among 21 patients positive for AFP，12 cases were transferred into negative AFP and serum AFP level in 8 cases decreased significantly,In the No-touch RFA group, among 20 patients positive for AFP，14 cases were transferred into negative AFP and serum AFP level in 5 cases decreased significantly during the period of 1-6 months after RFA treatment,and the difference in AFP preoperative and postoperative levels between the two groups was statistically significant (P<0.05). Regular follow-up to 24 months after RFA treatment showed that the tumor-free survival rate was 47.72% (21/44) in the M-RFA group and 68.00% (34/50) in the No-touch RFA group, and the difference between the two groups was statistically significant (P < 0.05).Conclusion Real-time CEUS guided No-touch RFA treatment of liver tumors is helpful to improve the total tumor necrosis rate, with significant efficacy and high tumor-free survival rate, and has important application value. |
| Key words: Contrast-enhanced ultrasound Radiofrequency ablation Liver tumors |
