超声引导下微波消融术联合TACE治疗特殊部位中晚期原发性肝癌的疗效及安全性分析

目的：探讨超声引导下微波消融术联合经肝动脉化疗栓塞（TACE）治疗特殊部位中晚期原发性肝癌的疗效，并分析其及安全性。方法：选择2015年1月至2018年1月我院收治的特殊部位中晚期原发性肝癌的患者120例，按照随机数字表法分为对照组和观察组，各60例。对照组给予单纯TACE术治疗，观察组给予超声引导下微波消融术联合TACE术治疗，比较两组治疗效果，肝功能指标血清总胆红素（TBIL）、结合胆红素（DBIL）、谷丙转氨酶（ALT）和白蛋白（Alb）]，术后并发症，住院时间和住院费用，术后6个月、1年、2年生存率。结果：观察组治疗有效率86.67%高于对照组的68.33%（P<0.05）。治疗后，观察组TBIL、DBIL、ALT水平低于对照组（P<0.05），Alb水平高于对照组（P<0.05）。观察组术后恶心呕吐、发热、肝区疼痛发生率与对照组无显著差异（P>0.05）。观察组住院时间长于对照组（P<0.05），住院费用高于对照组（P<0.05）。观察组术后6个月、术后1年和术后2年生存率分别为95%、90.00%、80.00%，均高于对照组的80.0%、75.00%、61.67%（P<0.05）。结论：超声引导下微波消融术联合TACE术治疗特殊部位中晚期原发性肝癌疗效较好，能够明显改善患者肝功能，提高术后短期生存率。

Curative effect and safety of ultrasound-guided microwave ablation combined with TACE in the treatment of advanced primary liver cancer in special parts

Objective: To investigate the curative effect and safety of ultrasound-guided microwave ablation combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced primary liver cancer in special parts. Methods: One hundred and twenty patients with advanced primary liver cancer in special parts who were admitted to the hospital during the period from January 2015 to January 2018 were selected. They were divided into the control group and the observation group by the random number table method, 60 cases in each group. The control group was treated by TACE alone while the observation group was treated by ultrasound-guided microwave ablation combined with TACE. The therapeutic effects, liver function indexes serum total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT) and albumin (Alb)], postoperative complications, length of hospital stay, hospitalization costs, postoperative 6-month, 1-year and 2-year survival rates were compared between the two groups. Results: The effective rate of treatment in the observation group was higher than that in the control group (86.67% vs 68.33%) (P<0.05). Levels of TBIL, DBIL and ALT in the observation group were lower than those in the control group after treatment (P<0.05), and the level of Alb was higher than that in the control group (P<0.05). There was no significant difference between the two groups in the incidence of postoperative nausea and vomiting, fever or liver pain (P>0.05). The length of hospital stay and hospitalization costs of the observation group were longer/more than those of the control group (P<0.05). The postoperative 6-month, 1-year and 2-year survival rates of the observation group (95%, 90.00%, 80.00%) were higher than those of the control group (80.0%, 75.00%, 61.67%) (P<0.05). Conclusion: Ultrasound-guided microwave ablation combined with TACE is effective in the treatment of advanced primary liver cancer in special parts. It can significantly improve the liver function and short-term survival rate of patients.