| Liver malignancies are divided into primary and secondary hepatocellular carcinoma,of which hepatocellular carcinoma accounts for about 90% of primary hepatocellular carcinoma.Worldwide,the incidence of hepatocellular carcinoma has been high for a long time,with epidemiological statistics,in 2020,there were 905677 new cases of hepatocellular carcinoma and 830,180 deaths,and the incidence regions are mainly in East and Southeast Asia.As a large country with hepatitis B,primary liver cancer is the 4th most common malignant tumor and the 2nd cause of death,which seriously threatens the life and health of our people,and surgical resection has been the first choice of treatment for early-stage liver cancer.In recent years,with the development of imaging technology and the increasing application of physical therapy in clinical practice,microwave ablation has provided a new treatment means for patients with small hepatocellular carcinoma and those who have lost the chance of surgery,which is less invasive,shorter hospital stay and less expensive than traditional surgery,and is gradually accepted by patients and their families.Objective To study the therapeutic effects and safety of ultrasound-guided microwave ablation for hepatocellular carcinoma.Methods A total of 92 patients with liver cancer admitted to the Affiliated Hospital Of Yangzhou University from January 2018 to September 2021 were retrospectively analyzed,including 39 cases of ultrasound-guided microwave ablation(MWA)and 53 cases of surgical resection.The length of hospital stay,postoperative liver function changes,postoperative complications and tumor-free survival and survival rates at 1,2and 3 years after surgery were compared after selecting the two different treatment methods,and the efficacy of the two treatment methods was studied in a controlled manner.Results.1.length of hospitalization of patients: 11.38±5.24 days in the microwave ablation group and 19.58±6.09 days in the surgical group,with a p-value of 0.001.The data of the two groups were statistically different,and the length of hospitalization of patients in the microwave ablation group was shorter than that of patients in the surgical group.2.Postoperative liver function recovery: There was no significant difference in the preoperative albumin level,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)between the two groups.The liver function recovery of the two groups was recorded and analyzed on the third day,one month and three months after surgery,in which the ALT of the patients in the microwave ablation group was100.24±66.23 U/L on the third day after surgery and AST In the microwave ablation group,ALT was 100.24±66.23 U/L and AST was 91.32±63.87 U/L on the third day after surgery,ALT was 36.62±27.03 U/L and AST was 33.21±17.83 U/L at one month after surgery,and ALT was 34.85±27.01 U/L and AST was 32.10±19.8 U/L at three months after surgery.The ALT was 235.57±222.59 U/L and AST was 295.43±104.30U/L on the third postoperative day,ALT was 92.61±113.76 U/L and AST was51.29±46.43 U/L at one month postoperatively,and ALT was 50.92±41.95 U/L and AST was 41.87±344.48 U/L at three months postoperatively.The P values of ALT on the third postoperative day,one month postoperative,and three months postoperative and AST on the first postoperative month were less than 0.05,which were statistically significant,suggesting that the recovery of liver function was faster in the microwave ablation group.3.Among the 39 patients in the microwave ablation group,4 patients(10.3%)had serious complications during the perioperative period,including 1 case of peritoneal effusion,1 case of pleural effusion and 2 cases of hyperthermia,all of which disappeared after conservative treatment.There were 53 patients in the surgical group,of which 11 patients(20.8%)had serious complications during the perioperative period,including 3 cases of incisional infection,2 cases of hyperthermia,3 cases of peritoneal effusion and 2 cases of pleural effusion,among which 1 patient with pleural effusion was a 77-year-old male,who recovered after ultrasound-guided closed drainage of the chest cavity,and the rest of the patient’s symptoms disappeared after conservative treatment.The incidence of postoperative complications in the ablation group was less than that in the surgery group.4.Postoperative survival rate: The tumor-free survival rates of patients in the microwave ablation group were 71.79%,53.84% and 38.46% at 1,2 and 3 years after surgery,respectively,and the overall survival rates at 1,2 and 3 years after surgery were89.74%,69.23% and 58.97%,respectively.The tumor-free survival rates at 1,2,and 3years after surgery were 75.47%,60.38%,and 47.17%,respectively,and the overall survival rates at 1,2,and 3 years after surgery were 99%,77.36%,and 52.83%,respectively,for patients in the surgical group.There was no statistical difference in the postoperative tumor-free survival rate and overall survival rate between the two groups(P > 0.05).CONCLUSION This study showed that for patients with CNLC stage Ⅰ a and some stage Ⅰ b hepatocellular carcinoma(i.e.,single tumor diameter ≤5 cm,or 2-3tumors with maximum diameter ≤3 cm),microwave ablation had similar postoperative survival rates as surgical resection,and the patients treated with microwave ablation had shorter hospitalization time,faster recovery of liver function,and fewer complications,which is a rapid and effective treatment and is worth promoting clinically. |
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