高强度聚焦超声联合人工液胸治疗不可切除小儿肝母细胞瘤短期疗效研究*

目的 探讨采用高强度聚焦超声(HIFU)联合人工液胸治疗不可切除的小儿肝母细胞瘤(HB)短期疗效。方法 2018年6月～2020年6月我院收治的不可切除的HB患儿48例,采用随机数字表法将患儿分为对照组24例和观察组24例,分别给予HIFU或HIFU联合人工液胸治疗,观察12 w。结果 在治疗12 w末,观察组有效率为87.5%,显著高于对照组的62.5%(P＜0.05);观察组血清ALT、AST和AFP水平分别为(72.6±26.1)U/L、(61.0±30.3)U/L和(43.1±5.3)μg/L,显著低于对照组【分别为(117.5±30.2)U/L、(116.6±37.8)U/L和(155.2±6.1)μg/L,P＜0.05】,而血红蛋白水平为(96.4±26.1)g/L,显著高于对照组【(90.7±23.6)g/L,P＜0.05】;两组血清IgM、IgG、IgA和补体C3、C4水平比较,差异无统计学意义(P＞0.05);在治疗期间,观察组发热、肋骨受损、皮肤烫伤、腹腔积液和创伤性湿肺等并发症发生率为4.2%,显著低于对照组的29.2%(P＜0.05)。结论 采用人工液胸保护下的HIFU治疗不可切除的HB患儿短期临床疗效确切,能有效降低并发症发生率,值得临床验证。

Short-term efficacy of high intensity focused ultrasound with auxiliary artificial plethorax in the treatment of children with unresectable hepatoblastoma

Objective The purpose of this study was to investigate the short-term efficacy of high intensity focused ultrasound (HIFU) with auxiliary artificial plethorax (AAP) in the treatment of children with unresectable hepatoblastoma (HB). Methods 48 children with unresectable HB were admitted to our hospital between June 2018 and June 2020, and the children were randomly divided into control and observation group, with 24 cases in each, receiving HIFU or HIFU with AAP therapy. All patients were followed-up for 12 weeks. Serum immunoglobulin M (IgM), IgG and IgA were detected by immunoturbidimetry, and serum complement C3 and C4 levels were detected by scattering turbidimetry. Results At the end of 12 weeks of treatment, the effective rate in the observation group was 87.5%, significantly higher than 62.5% in the control group (P<0.05); serum ALT, AST and AFP levels in the observation group were(72.6±26.1)U/L, (61.0±30.3)U/L and(43.1±5.3)μg/L, significantly lower than (117.5±30.2)U/L, (116.6±37.8)U/L and (155.2±6.1)μg/L, respectively, P＜0.05], while hemoglobin level was (96.4±26.1)g/L, significantly higher than (90.7±23.6)g/L, P＜0.05] in the control; there were no significant differences respect of serum IgM, IgG, IgA, complement C3 and C4 levels between the two groups (P＞0.05); during the treatment, the incidences of complications, such as fever, skin burning, ascites and traumatic wet lung in the observation group was 4.2%, significantly lower than 29.2%(P＜0.05) in the control. Conclusion The HIFU with AAP in the treatment of children with unresectable HB is short-termly efficacious, which could effectively reduce the incidence of complications, and worthy of clinical verification.