PEI 联合 HIFU 治疗不能手术切除的中晚期原发性肝癌的临床研究

摘要

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.%目的：探讨在镇静镇痛下行无水乙醇注射术（PEI），能否提高高强度聚焦超声（HIFU）治疗不能手术切除的中晚期原发性肝癌（PCL）的能量沉积及其治疗效率。方法将临床确诊的不能手术切除的中晚期 PCL 患者36例分为 PEI 联合 HI-FU 治疗组（联合组，n＝23）和单纯 HIFU 治疗组（HIFU 组，n＝13）；联合组于消融前30 min 向瘤体内注入99．70％无水乙醇与碘化油（9∶1）混合液10 mL，HIFU 组以0．9％生理盐水10 mL 替代，比较两组患者消融的能效因子（EEF）及辐照时间。结果联合组、HIFU 组消融 EEF 分别为（13．82±4．26）、（25．63±6．31）J／ mm3，联合组明显低于 HIFU 组（P ＜0．05）；辐照时间分别为（1468．28±253．21）、（2352．56±463．34）s；联合组辐照时间明显缩短（P ＜0．05）。结论PEI 能够增强 HIFU 消融能量沉积，能够提高 HIFU 治疗不能手术切除的 PCL 的治疗效率。