目的 系统性评价三维可视化技术辅助肝细胞癌消融治疗的有效性和安全性.方法 本研究根据PRISMA指南完成,PROSPERO注册号:CRD42023488398.计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国知网数据库、万方数据库、维普数据库和中国生物医学文献数据库中公开发表的有关三维可视化技术辅助肝细胞癌消融治疗的所有中、英文文献,检索时间为自建库至2023年3月.对纳入的研究进行质量评价和数据提取后,采用RevMan 5.4软件进行Meta分析.结果 最终纳入11篇文献,共972例患者,其中447例采用三维可视化技术辅助消融(3D组),525例采用常规二维影像技术辅助消融(2D组).Meta分析结果显示,3D组首次治疗成功率(OR=5.43,95%CI:2.64～11.18,P<0.001)、技术有效率(OR=6.15,95%CI:3.23～11.70,P<0.001)、完全消融率(OR=2.50,95%CI:1.08～5.78,P=0.03)均显著高于2D组;在安全性方面,严重并发症发生率(OR=0.45,95%CI:0.24～0.87,P=0.02)、局部复发率(OR=0.35,95%CI:0.17～0.72,P=0.004)和局部肿瘤进展率(OR=0.29,95%CI:0.16～0.50,P<0.001)均明显低于2D组;两组的轻度并发症发生率比较,差异无统计学意义(P>0.05).结论 三维可视化技术辅助肝细胞癌消融治疗安全可行,可以提高消融率,并降低严重并发症发生率、局部复发率及局部肿瘤进展率,在临床中有重要应用价值.
Efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma:A Meta-analysis
Objective To systematically evaluate the efficacy and safety of three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma.Methods This study was conducted according to PRISMA guidelines,with a PROSPERO registration number of CRD42023488398.PubMed,Embase,Web of Science,the Cochrane Library,CNKI,Wanfang Data,VIP,and CBM were searched for Chinese and English articles on three-dimensional visualization technology in assisting ablation therapy for hepatocellular carcinoma published up to March 2023.After quality assessment and data extraction of the studies included,RevMan 5.4 software was used to perform the meta-analysis.Results A total of 11 studies were included,with 972 patients in total,among whom 447 underwent ablation assisted by three-dimensional visualization technology(3D group)and 525 underwent ablation assisted by traditional two-dimensional imaging technology(2D group).The meta-analysis showed that compared with the 2D group,the 3D group had significantly higher success rate of first-time ablation treatment(odds ratio[OR]=5.43,95%confidence interval[CI]:2.64—11.18,P<0.001),technical efficiency(OR=6.15,95%CI:3.23—11.70,P<0.001),and complete ablation rate(OR=2.50,95%CI:1.08—5.78,P=0.03),as well as significantly lower incidence rate of major complications(OR=0.45,95%CI:0.24—0.87,P=0.02),local recurrence rate(OR=0.35,95%CI:0.17—0.72,P=0.004),and local tumor progression rate(OR=0.29,95%CI:0.16—0.50,P<0.001),while there was no significant difference in the incidence rate of mild complications between the two groups(P>0.05).Conclusion Three-dimensional visualization technology is safe and feasible in assisting ablation therapy for hepatocellular carcinoma and can improve ablation rate and reduce the incidence rate of serious complications,local recurrence rate,and local tumor progression rate,thereby showing an important application value in clinical practice.
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