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目的研究微波消融(MWA)治疗肝转移癌的临床疗效及影响生存率的相关因素。方法收集经检查确诊为肝转移癌行MWA治疗的100例患者的病历资料,所有病例原发肿瘤均已控制。MWA 1个月后根据患者情况选行B超、超声造影、CT、MRI检查判断疗效。术后1个月后行B超、肝功能及肿瘤标志物检查,定期复查。定时进行电话或门诊随访。结果不同肿瘤直径患者的完全消融率比较,差异有统计学意义(P﹤0.05);不同肿瘤直径患者的复发率比较,差异无统计学意义(P﹥0.05)。原发肿瘤部位、肿瘤直径、肿瘤数目、分化程度与患者的生存率有关(P﹤0.05);性别、年龄、是否肝外转移与患者的生存率无关(P﹥0.05)。多因素分析结果表明原发肿瘤部位与肿瘤数目均为肝转移癌患者预后的独立危险因素(P﹤0.05)。结论 MWA对治疗肝转移癌的治疗效果良好,具有操作简单、耐受性好等优点;原发肿瘤部位与肿瘤数目均为肝转移癌患者预后的独立危险因素。
Objective To study the clinical effects of microwave ablation (MWA) in the treatment of liver metastases and the related factors that influence the survival rate. Methods The medical records of 100 patients who had been diagnosed with liver metastases by MWA were collected. The primary tumors of all cases were controlled. MWA 1 month after the election according to the patient’s condition B ultrasound, contrast-enhanced ultrasound, CT, MRI examination to determine the efficacy. After 1 month after the line B, liver function and tumor markers, regular review. Regular telephone or outpatient visits. Results The complete ablation rate of patients with different tumor diameters was significantly different (P <0.05). There was no significant difference in the recurrence rates between different tumor diameters (P> 0.05). The primary tumor location, the diameter of the tumor, the number of the tumor and the degree of differentiation were related to the survival rate of the patients (P <0.05). The sex, age and extrahepatic metastasis had no relation with the survival rate of patients (P> 0.05). Multivariate analysis showed that both the primary tumor location and the number of tumors were independent risk factors for the prognosis of patients with liver metastasis (P <0.05). Conclusion MWA has a good effect on the treatment of liver metastases and has the advantages of simple operation and good tolerability. The primary tumor sites and the number of tumors are independent risk factors for the prognosis of patients with liver metastases.