国际医学放射学杂志2025,Vol.48Issue(4):409-414,6.DOI:10.19300/j.2025.L22065
恶性肝肿瘤射频消融术后胆道严重并发症的发生率及危险因素分析
Incidence and risk factors of severe biliary-related complications after radio-frequency ablation for malignant liver tumors
摘要
Abstract
Objective To analyze the incidence and related risk factors of severe biliary complications following percutaneous ultrasound-guided radiofrequency ablation(RFA)for malignant liver tumors.Methods Clinical data,laboratory examination,and imaging findings from 769 patients with malignant liver tumors who underwent percutaneous ultrasound-guided RFA were retrospectively collected.There were a total of 1,212 lesions with an average maximum diameter(1.9±0.8)cm.Based on whether severe biliary complications occurred after RFA,patients were divided into a complication group(9 cases)and a control group(760 cases).Clinical variables,laboratory indicators,pathological tumor types,and imaging featureswere compared between groups using Fisher's exact test or the Mann-Whitney U test.Multivariate Logistic regression analysis was performed to identify independent risk factors for severe biliary complications.Results The incidence of severe biliary complications after RFA was 1.2%(9/769).Compared to the control group,the complication group had a higher proportion of patients with a history of cholecystectomy or choledochojejunostomy,preoperative albumin(ALB)<28 g/L,liver metastases from biliary system tumors,and tumors located near critical anatomical sites(all P<0.05).Multivariate Logistic regression analysis showed that a history of cholecystectomy or choledochojejunostomy(OR=22.563,95%CI:4.320-117.844),preoperative ALB<28 g/L(OR=175.982,95%CI:20.164-1 535.921),and liver metastases from biliary system tumors(OR=17.437,95%CI:3.143-96.728)were independent risk factors for severe biliary complications after RFA(all P<0.05).Conclusions Severe biliary complications following RFA for malignant liver tumors are rare and influenced by multiple factors.A history of cholecystectomy or choledochojejunostomy,preoperative ALB<28 g/L,and liver metastasis from biliary system tumors are independent risk factors for severe biliary complications.关键词
肝肿瘤/超声引导/导管消融术/胆道相关并发症Key words
Liver tumor/Ultrasound-guided/Catheter ablation/Biliary-related complication分类
医药卫生引用本文复制引用
鲁琴,吴薇,张仲一,王凇,杨薇,严昆,陈敏华..恶性肝肿瘤射频消融术后胆道严重并发症的发生率及危险因素分析[J].国际医学放射学杂志,2025,48(4):409-414,6.基金项目
山西省基础研究计划项目(202403021222418) (202403021222418)