• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

肝癌射频消融术后即刻增强CT复查造影剂外溢的发生及其临床意义

The occurrence and clinical significance of contrast agent spillover on immediate enhanced CT reexamination after radiofrequency ablation of liver cancer

摘要:

目的 探讨肝癌射频消融后即刻增强CT扫描发生造影剂外溢与术后临床严重出血的关系,分析其发生的风险因素. 方法 回顾性分析自2016年1月至2017年1月行肝癌射频消融治疗的肝癌患者199例,共行消融治疗232例次,根据术后增强CT扫描穿刺针道或肝周是否存在造影剂外溢分为2组,一组为造影剂外溢组,另一组为无造影剂外溢组,统计其基本临床资料、出血风险相关的实验室资料以及影像学资料以分析其对临床治疗的影响及其发生的风险因素.据资料不同分别采用t检验、x2检验或logistic回归检验进行统计学分析.结果 199例患者,共行消融治疗232例次,其中男性138例,女性61例,病灶平均直径(3.42±2.30) cm.消融后即刻增强CT扫描穿刺针道发生造影剂外溢共30例次(12.93%),患者术后均无严重出血,未行特殊临床干预;其余202例次患者为无造影剂外溢组,但其中2例患者发生严重出血进行了相应临床干预.单因素分析可见两组患者:是否经胸腔穿刺(P=0.019)、合并有肝硬化(P<0.001)、肝癌病理类型(P=0.013)差异有统计学意义,其余临床资料(年龄、病灶大小、肝功能Child-Pugh分级、术前血红蛋白、血小板计数、凝血酶原时间、活化部分凝血活酶时间、国际标准化比率以及穿刺针数、穿刺道长度)差异均无统计学意义.两组患者术后血红蛋白(P=0.160)、术前-术后血红蛋白变化值(P=0.999)以及住院天数(P=0.730)差异亦无统计学意义.Logistic回归分析显示合并有肝硬化(OR=5.59,P< 0.001)、经胸膜腔穿刺(OR=2.67,P=0.021)可能为肝癌射频消融术后即可CT增强扫描发生造影剂外溢的风险因素. 结论 造影剂外溢在消融后即刻增强CT疗效评价中并不少见,对于术后严重出血的发生并无预测意义且无需过度临床干预,肝硬化及经胸膜腔穿刺可能是其发生的风险因素.对于术后无造影剂外溢的患者也不可忽视其术后发生严重出血的风险.

更多
abstracts:

Objective To investigate the relationship between radiofrequency ablation immediately after enhanced CT scanning and the occurrence of contrast agent spillover and postoperative severe bleeding,and analyze the risk factors for hepatocellular carcinoma (HCC).Methods A retrospective analysis of 199 patients with hepatocellular carcinoma who underwent radiofrequency ablation of liver cancer in our hospital from January 2016 to January 2017 was reviewed.A total of 232 cases were treated with ablation.The agent spillovers were divided into two groups,one for the contrast agent spill group and the other for the non-contrast agent spill group.Its basic clinical data,laboratory data related to the risk of bleeding,and imaging data were analyzed to explore their clinical treatment effects and the risk factors for their occurrence.According to different data,t-test,x2 test or logistic regression test was used for statistical analysis.Results In 199 patients,a total of 232 cases were treated with ablation,including 138 males and 61 females.The average age was (57.56 ± 12.09) years and the average diameter of lesions was (3.42 ± 2.30) cm.A total of 30 cases (12.93%) of contrast agent spillover occurred immediately after the ablation of CT scanning needle.There were no severe bleeding and no special clinical intervention after the operation.The other 202 cases were non-contrast agent spill group,but 2 cases had severe bleeding and had corresponding clinical interventions.Univariate analysis showed that there were statistically significant differences in thoracentesis (P =0.019),complications of cirrhosis (P < 0.001),and histological types of liver cancer (P =0.013),and other clinical data [age,lesion size].There were no significant differences in Child-Pugh classification,preoperative hemoglobin (HGB),platelet count,prothrombin time,APTT,international standardized ratio,number of puncture needles,and puncture length.There was also no significant difference in postoperative HGB (P =0.160),preoperative-postoperative HGB change (P =0.999),and length of hospital stay (P =0.730) between the two groups.Logistic regression analysis showed that with cirrhosis (OR =5.59,P < 0.00 1),transthoracic puncture (OR =2.67,P =0.021) may be a risk factor for contrast agent spillover after CT-enhanced CT scan in patients with hepatocellular carcinoma.Conclusion Contrast agent spillover is not uncommon in the evaluation of curative effect of CT immediately after ablation (12.93%).It is not predictive for the occurrence of postoperative severe bleeding and does not require excessive clinical intervention.Liver cirrhosis and transthoracic cavity puncture may be the risk factors for its occurrence.The risk of severe postoperative bleeding should not be ignored for patients who have no contrast agent spills after surgery.

More
  • 浏览:286
  • 下载:148

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷