摘要
目的本研究旨在系统评价射频消融术(RFA)联合无水乙醇注射(PEI)治疗肝癌的疗效及安全性,为临床实践与研究提供参考。方法计算机检索Cochrane Library、Pub Med、EMBase、Web of Science、CBM、CNKI、VIP及Wanfang八大数据库,同时辅以其他检索,收集所有相关的临床对照试验(CCT)。由2位评价员按照研究计划书进行文献筛选和资料提取,并对纳入文献的质量进行评价后,使用Rev Man 5.3软件进行Meta分析。结果共纳入15个CCT(1 374例患者)。Meta分析结果显示:RFA+PEI组的1、2、3年生存率及肿瘤完全坏死率高于RFA组,局部复发率低于RFA组,差异均有统计学意义(P<0.05);除发热外,RFA+PEI组不增加其他并发症和不良反应的发生率。RFA+PEI组1年生存率、肿瘤完全坏死率高于PEI组,局部复发率低于PEI组,差异均有统计学意义(P<0.05)。结论与单纯RFA或单纯PEI治疗相比,RFA联合PEI治疗肝癌能明显提高患者生存率和肿瘤完全坏死率、降低局部复发率,并具有较好的临床安全性。但其长期疗效和安全性评价尚需更多大样本高质量的临床研究进一步验证。
Objective To investigate the efficacy and safety of radio - frequency ablation（ RFA）combined with percutaneous ethanol injection（PEI）in the treatment of liver cancer and to provide references for clinical practice and research. Methods A computer - based retrieval was made in eight major databases which were Cochrane Library,PubMed,EMBase, Web of Science,CBM,CNKI,VIP and Wanfang and other auxiliary retrieval was also made to collect all relevant controlled clinical trials（CCT）. After two researchers made literature screening,extracted data and evaluated the quality of literature included according to research plan,meta - analysis was undertaken using RevMan 5. 3 software. Results A total of 15 CCT with 1 374 patients were included. The results of Meta - analyses showed：RFA ＋ PEI group was higher in 1 - year,2 - year and 3 - year survival rates and complete necrotic rate and was lower in locoregional recurrence rate than RFA group（P 〈 0. 05）;apart from fever,RFA ＋ PEI group did not increase the incidence rates of other complications and adverse reactions. RFA ＋ PEI group was higher in 1 - year survival rate and complete necrotic rate and was lower in locoregional recurrence rate than PEI group （P 〈 0. 05）. Conclusion Compared with pure RFA or pure PEI treatment,RFA combined with PEI can improve the survival rate and complete necrotic rate and lower locoregional recurrence rate with better clinical safety,while its long - term efficacy and safety need further verification by more high - quality clinical researches with lager samples.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第11期1322-1328,共7页
Chinese General Practice
关键词
肝肿瘤
射频消融术
无水乙醇注射
临床对照试验
META
分析
Liver neoplasms
Radio - frequency ablation
Absolute ethanol injection
Controlled clinical trial
Meta - analysis
作者简介
通信作者：蔺淑梅，710061陕西省西安市，西安交通大学第一附属医院感染科；E-mail：linshumei123@126．com
