高强度聚焦超声治疗结直肠癌肝转移的疗效及安全性研究

A Study on the Efficacy and Safety of High-Intensity Focused Ultrasound Treatment for Colorectal Cancer Liver Metastases

摘要: 目的：探讨高强度聚焦超声即海扶刀(High-Intensity Focused Ultrasound, HIFU)在治疗结直肠癌肝转移中的疗效及安全性，并与腹腔镜肝部分切除术和消融术进行比较。方法：回顾性分析结直肠癌肝转移患者，根据治疗方式分为A组海扶刀组(34例)、B组腹腔镜组(25例)和C组消融组(25例)。观察并分析三组患者的术后疾病控制率、肿瘤标志物水平(术前及术后CA19-9、CEA)、肝功能指标(术前及术后的ALT、AST)、术后并发症(发热及疼痛)以及住院天数。结果：三组在疾病控制率和肿瘤标志物水平变化上无显著差异(P > 0.05)。A组的术后AST水平显著低于B组和C组(P < 0.05)；A组的术后发热及疼痛发生率均显著低于B组和C组(P < 0.05)；A组的住院天数显著低于B组和C组(P < 0.05)。结论：海扶刀治疗结直肠癌肝转移具有良好的安全性和患者耐受性，特别在降低术后肝功能损伤、发热、疼痛以及住院天数方面表现出明显优势，是传统手术和消融治疗的重要补充。

Abstract: Objective: To investigate the efficacy and safety of high-intensity focused ultrasound (HIFU) in the treatment of colorectal cancer liver metastases and to compare it with laparoscopic liver resection and ablation therapy. Methods: A retrospective analysis of patients with colorectal cancer liver metastases was conducted, categorizing them into three groups based on treatment modalities: Group A (HIFU group, 34 cases), Group B (Laparoscopic group, 25 cases), and Group C (Ablation group, 25 cases). Postoperative disease control rate, tumor marker levels (preoperative and postoperative CA19-9, CEA), liver function indices (preoperative and postoperative ALT, AST), postoperative complications (fever and pain), and hospital stay duration were observed and analyzed among the three groups. Results: There were no significant differences in disease control rate and changes in tumor marker levels among the three groups (P > 0.05). Group A exhibited significantly lower postoperative AST levels compared to Groups B and C (P < 0.05); the incidence of postoperative fever and pain in Group A was significantly lower than in Groups B and C (P < 0.05); and the length of hospital stay in Group A was significantly shorter than in Groups B and C (P < 0.05). Conclusion: HIFU treatment for colorectal cancer liver metastases demonstrates good safety and patient tolerability, particularly showing significant advantages in reducing postoperative liver function damage, fever, pain, and hospital stay duration, making it an important adjunct to traditional surgery and ablation therapy.