Su Xiu-Feng, Li Na, Chen Xu-Fang, Zhang Lei, Yan Ming
Department of Geriatric Gastroenterology, Qilu Hospital, Shandong University, Jinan, China; Department of Oncology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China.
Department of Rheumatology, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China.
Hepat Mon. 2016 May 23;16(7):e34588. doi: 10.5812/hepatmon.34588. eCollection 2016 Jul.
Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most frequently used thermal ablation methods for the treatment of liver cancer. Liver abscess is a common and severe complication of thermal ablation treatment.
The objective of this study was to determine the incidence and risk factors of liver abscess formation after thermal ablation of liver cancer.
The clinical data of 423 patients who underwent 691 thermal ablation procedures for liver cancer were collected in order to retrospectively analyze the basic characteristics, incidence, and risk factors associated with liver abscess formation. Patients with multiple risk factors for liver abscess formation were enrolled in a risk factor group, and patients with no risk factors were enrolled in a control group. The chi-square test and multiple logistic regression analysis were used to analyze the relationship between the occurrence of liver abscesses and potential risk factors.
Two hundred and eight patients underwent 385 RFA procedures, and 185 patients underwent 306 MWA procedures. The total incidence of liver abscesses was 1.7%, while the rates in the RFA group (1.8%) and MWA groups (1.6%) were similar (P > 0.05). The rates of liver abscesses in patients who had child-pugh class B and class C cirrhosis (P = 0.0486), biliary tract disease (P = 0.0305), diabetes mellitus (P = 0.0344), and porta hepatis tumors (P = 0.0123) were 4.0%, 6.7%, 6.5%, and 13.0%, respectively. There was a statistically significant difference between these four groups and the control group (all P < 0.05). The incidence of liver abscesses in the combined ablation and percutaneous ethanol injection (PEI) group (P = 0.0026) was significantly lower than that of the ablation group (P < 0.05).
The incidence of liver abscesses after liver cancer thermal ablation is low. Child-Pugh Class B and Class C cirrhosis, biliary tract disease, diabetes mellitus, and porta hepatis tumors are four significant risk factors. Combined ablation and PEI reduces the rate of liver abscesses.
射频消融（RFA）和微波消融（MWA）是治疗肝癌最常用的热消融方法。肝脓肿是热消融治疗常见且严重的并发症。
本研究旨在确定肝癌热消融术后肝脓肿形成的发生率及危险因素。
收集423例行691次肝癌热消融术患者的临床资料，回顾性分析肝脓肿形成的基本特征、发生率及相关危险因素。将存在多个肝脓肿形成危险因素的患者纳入危险因素组，无危险因素的患者纳入对照组。采用卡方检验和多因素logistic回归分析肝脓肿发生与潜在危险因素之间的关系。
208例患者行385次RFA术，185例患者行306次MWA术。肝脓肿总发生率为1.7%，RFA组（1.8%）和MWA组（1.6%）发生率相似（P>0.05）。Child-Pugh B级和C级肝硬化患者（P = 0.0486）、胆道疾病患者（P = 0.0305）、糖尿病患者（P = 0.0344）及肝门部肿瘤患者（P = 0.0123）肝脓肿发生率分别为4.0%、6.7%、6.5%和13.0%。这四组与对照组之间差异有统计学意义（均P<0.05）。联合消融与经皮乙醇注射（PEI）组肝脓肿发生率（P = 0.0026）显著低于单纯消融组（P<0.05）。
肝癌热消融术后肝脓肿发生率较低。Child-Pugh B级和C级肝硬化、胆道疾病、糖尿病及肝门部肿瘤是四个重要危险因素。联合消融与PEI可降低肝脓肿发生率。
