中文摘要：

目的 探讨经皮穿刺射频消融联合瘤体边缘无水乙醇注射治疗大血管旁肝癌的效果.方法 将75例大血管旁肝癌患者分为治疗组和对照组,治疗组38例患者接受经皮穿刺射频消融＋无水乙醇注射方法治疗,对照组37例患者接受经皮穿刺射频消融方法治疗.选择肿瘤坏死率、甲胎蛋白水平、局部复发率和中位生存期、累积生存率为评价指标,比较两种治疗方法的效果.组间比较采用t检验或x2检验,生存期、累积生存率采用生存分析法与log-rank检验.结果 治疗组和对照组的肿瘤完全坏死率分别为84.2%,54.1%（P〈0.01）.治疗后1、3、6,12个月治疗组和对照组患者的甲胎蛋白水平分别为（105.0±35.5）μg/L,（28.4±4.3）pg/L,（58.6±6.7）μg/L、（89.5±12.5）μg/L和（137.2±34.6）μg/L,（84.2±18.4）μg/L、（106.6±20.3）μg/L、（173.7±32.0）μg/L,治疗组明显低于对照组（P〈0.05）.治疗组和对照组在3、6、12、24个月的局部复发率分别为2.6%、7.9%、13.2%、31.6%和10.8%、21.6%、40.5%、62.1%（P〈0.01）.治疗组和对照组患者中位生存期分别为（28.0±2.8）个月、（19.0±3.6）个月,6、12、24、36个月的累积生存率分别为84.2%,78.9%、60.5%、31.6%和78.4%、67.6%、37.8%、8.1%.结论 瘤体边缘无水乙醇注射作为经皮穿刺射频消融的补充治疗,可以显著提高大血管旁肝癌的疗效,明显降低局部复发率,提高远期生存率.

英文摘要：

Objective To explore the effects of percutaneous transhepatic radiofrequency ablation （PRFA） combined with tumor edge of percutaneous absolute ethanol injection （PEI） on liver cancer adjacent to major blood vessels. Methods Seventy five patients with liver cancer adjacent to major blood vessels were randomly divided into two groups： PRFA＋PEI therapy group （38 cases） and PRFA control group （37 cases）. Tumor necrosis rate, AFP levels, local recurrence rate, median for survival time and cum survival were used as the evaluation index to evaluate the efficacies of the two methods. Results Tumor necrosis rates of the therapy group and the control group were 84.2% and 54.1 % （P 〈 0.01）, respectively; AFP levels of therapy group and control group at 1, 3,6 and 12 months after treatment were （105.0 ± 35.5） Mg/L, （28.4 ± 4.3）Mg/L, （58.6 ± 6.7） μg/L, （89.5 ± 12.5） μg/L and （137.2 ± 34.6） μg/L, （84.2 ± 18.4） μg/L, （106.6 ±20.3） Mg/L, （173.7 ± 32.0） Mg/L, respectively. The rates of therapy group was significantly lower than of control group. Local recurrence rates of the therapy group and control group were 2.6%, 7.9%, 13.2% and 31.6% vs 10.8%, 21.6%, 40.5% and 62.1% （P 〈 0.05） at 3,6,12 and 24 months after treatment, respectively.Median for survival time of the therapy group and control group were 28.0 ± 2.8 months and 19.0 ± 3.6months, respectively. Cum survival of the therapy group and control group were 84.2%, 78.9%, 60.5% and 31.6% vs 78.4%, 67.6%, 37.8% and 8.1% （P 〈 0.05） at 6,12,24 and 36 months after treatment, respectively.Conclusion PEI as a supplementary treatment of PRFA can effectively improve the treatment of liver cancer adjacent to major blood vessels and significantly reduce the local recurrence rate and improve long-term survival rates.