Abstract:

Objective　To study the value of microwave ablation guided by real-time contrast-enhanced ultrasound and fusion image in the treatment of patients with small liver cancer. Methods　A total of 84 patients with small liver cancer admitted to Huangshi Central Hospital from May 2019 to November 2020 were selected as the study samples. According to the treatment methods, they were divided into an observation group, taking microwave ablation guided by real-time contrast ultrasound and fusion image, and a control group, taking surgical treatment, with 42 cases each group. There were 23 males and 19 females in the observation group; they were (44.86±3.46) years old; there were 58 lesions; the longest lesion diameter was (1.56±1.07) cm. There were 25 males and 17 females in the control group; they were (43.60±3.50) years old; there were 61 lesions; the longest lesion diameter was (1.62±1.02) cm. The operation times, hospitalization times, and incidences of complications were compared between the two groups. The patients were followed up until November 2022. The disease progress and survival and death within 2 years were compared between the two groups. t, χ², and Log-rank tests were applied. Results　The operation time and hospitalization time in the observation group were shorter than those in the control group [(92.37±19.43) min vs. (142.16±21.83) min and (4.37±2.26) d vs. (9.42±2.81) d], with statistical differences between the two groups (t=11.041 and 9.076; both P<0.001). The total incidence of complications in the observation group was lower than that in the control group [9.52% (4/42) vs. 26.19% (11/42); χ²=3.977; P=0.046]. The local progression rate, mortality rate, and 2-year cumulative survival rate of the observation group were 35.71% (15/42), 28.57% (12/42), and 70.00% (28/40), respectively; and those of the control group were 33.33% (14/42), 30.95% (13/42), and 68.29% (28/41), respectively; there were no statistical differences (χ²=0.054 and 0.067; Log-rank=0.084; all P>0.05). Conclusion　Microwave ablation guided by real-time contrast-enhanced ultrasound and fusion image in the treatment of patients with small liver cancer is of great clinical value, minimally invasive, and safe.

Key words:

Small liver cancer, Microwave ablation, Contrast-enhanced ultrasound, Fusion image

摘要：

目的　探讨应用实时超声造影和融合影像导航下微波消融治疗小肝癌的临床价值。方法　将2019年5月至2020年11月黄石市中心医院收治的84例小肝癌患者纳入研究样本，根据治疗方式分为观察组（实时超声造影和融合影像导航下微波消融）及对照组（手术治疗）。观察组42例中，男23例，女19例，年龄（44.86±3.46）岁，病灶数58个，病灶长径（1.56±1.07）cm；对照组42例，男25例，女13例，年龄（43.60±3.50）岁，病灶数61个，病灶长径（1.62±1.02）cm。比较两组手术时间、住院时间、并发症发生情况；随访截止至2022年11月，比较两组患者病情进展程度、2年内存活及死亡情况。采用t检验、χ²检验、Log-rank检验进行统计分析。结果　观察组手术时间为（92.37±19.43）min、住院时间为（4.37±2.26）d，对照组分别为（142.16±21.83）min、（9.42±2.81）d，两组比较，差异均有统计学意义（t=11.041、9.076，均P<0.001）。观察组并发症总发生率为9.52%（4/42），低于对照组的26.19%（11/42），两组比较差异有统计学意义（χ²=3.977，P=0.046）。观察组局部进展发生率、病死率、2年累积生存率分别为35.71%（15/42）、28.57%（12/42）、70.00%（28/40），对照组分别为33.33%（14/42）、30.95%（13/42）、68.29%（28/41），差异均无统计学意义（χ²=0.054、0.067，Log-rank=0.084，均P>0.05）。结论　应用实时超声造影和融合影像导航下微波消融对治疗小肝癌具有重要临床价值，且手术具有创伤小、安全性高等优点。

关键词:

小肝癌, 微波消融, 超声造影, 融合影像