射频及手术切除在小肝癌治疗中价值的探讨  

The Value of Radiofrequency Ablation and Surgical Resection for Small Hepatocellular Carcinoma

作　　者：李立新[1] 叶胜龙[1] 杨毕伟[1] 干育红[1] 任正刚[1] 夏景林[1] 王艳红[1] 张博恒[1] 

机构地区：[1]复旦大学附属中山医院肝癌研究所,上海200032

出　　处：《中国临床医学》2004年第6期1011-1013,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :评价射频及手术切除在小肝癌治疗中的价值。方法 :分别对我院肝内科及肝外科随机选取的 2 0 0 3年采用射频和手术切除治疗小肝癌的病例各 10 0例 ,对两组在住院费用、住院天数、肝功能恢复时间、术后 1年复发率及并发症等方面进行比较。结果 :射频治疗组患者术后肝功能恢复时间为 9.0 9± 4 .5 9d ,少于手术组 10 .5 5± 3.0 9d(P <0 .0 1) ;射频治疗组患者术后并发症 (发热 ,黄疸 )比手术组患者明显少 (P <0 .0 0 1) ,且持续时间短 ;对于直径 3.0cm以下的肿瘤 ,射频治疗组患者术后 1年的肿瘤复发率等同于手术组 (p >0 .0 5 ) ,而直径在 3.0～ 5 .0cm的肿瘤 ,射频治疗组患者术后 1年的肿瘤复发率明显高于手术组 (P <0 .0 1) ;射频治疗组患者平均住院费用是 2 35 0 4 .2 8± 4 936 .6 2元 ,手术组为 2 2 6 6 3.6 6± 394 9.6 1元。两组基本相当 (p >0 .0 5 ) ;射频治疗组患者平均住院天数为 14 .4 9± 7.6 1d ,少于手术组 17.5 8± 4 .87d(P <0 .0 1)。结论射频治疗是一种创伤小、恢复快、安全性高的治疗方法 ,其对于 3cm以下的肿瘤的疗效等同于手术切除。且其治疗费用与手术切除相当。严格掌握射频治疗的指征是降低术后复发的关键。Objective: To discuss the value of radiofr eq uency ablation and surgical resection in treatment of small hepatocellular carci noma.Methods: One hundred patients with small hepatocellular carcinom a treated by radiofrequency ablation and another 100 patients treated by surgica l resection in 2003 were crroled in this study. The average hospital stay, hospi tal charge,the restorative time of liver function,the recurrence rate one year l ater after operation and complication were compared.Results: The average hospital stay, hospital charge,the restorat ive time of liver function,the recurrence rate one year later after operation in radiofrequency group were 14.49±7.61 days,23504.28±4936.62 yuan,9.09±4.59 da ys, 13.04%(tumor diameter<3.0cm),57.40%(tumor diameter:3.0～5.0cm)respectively. A nd the corresponding parameters were,17.58±4.87 days,22663.66±3949.61 yuan,10. 55±3.09 days,6.82%(tumor diameter<3.0cm);32.14%(tumor diameter:3.0～5.0cm) in s u rgical group. There were obvious distinctions between two groups in average hosp ital stay(P<0.01), the restorative time of liver function(P<0.01), the r ecurrence rate one year later after operation(tumor diameter:3.0～5.0cm,P<0. 0 1),and no obvious distinction in hospital charge(p>0.01), the recurrence rat e one year later after operation(tumor diameter<3.0cm)(p>0.05).The complicat ion(fever,icterus) in radiofrequency group was less than that in surgical group. The lasting time of complication in radiofrequency group was shorter than that i n surgical group.Conclusion:Radiofrequency ablation is a remedial method with fas t recovery,small scar and high safety.The treatment efficiency to tumor(diameter <3.0cm) after radiofrequency ablation was similar to that after surgical resecti on,and the hospital charge were same in two therapies. The key to decrease the r ecurrence rate after radiofrequency ablation is that we should strictly grasp th e indication of radiofrequency ablation.

关 键 词：射频治疗 患者 肿瘤 手术切除 小肝癌 术后 治疗中 等同 价值 平均 

分 类 号：R735[医药卫生—肿瘤] R197[医药卫生—临床医学]