射频消融术对乙肝病毒相关性肝癌患者肝功能的影响  

Analysis on the effect of radiofrequency ablation on liver function in patients with hepatitis B virus associated hepatocellular carcinoma

作　　者：王文欢[1] 郭汉斌[1] 夏长虹[1] 李国安[1] 任永强[1] 曹建彪[1] 

机构地区：[1]北京军区总医院全军肝病治疗中心,北京100700

出　　处：《北京医学》2014年第3期174-176,共3页Beijing Medical Journal

基　　金：吴阶平医学基金会研究基金(WJP-LD-2012075A)

摘　　要：目的探讨射频消融术(RFA)对乙型肝炎病毒(HBV)相关性肝癌(HCC)患者肝功能的影响。方法回顾性分析140例HBV相关HCC患者RFA术前、术后3 d、术后1个月肝功能指标,比较治疗前及治疗后肝功能变化情况及影响因素。结果 RFA术后3 d、1个月肝功能异常率分别为87.1%(122/140)、25.7%(36/140),差异有统计学意义(P<0.05)。肝功能Child-Pugh C级患者RFA术后1个月肝功能异常率为81.8%,明显高于A、B级患者(19.5%、23.1%,P均<0.05);消融范围≥3针者术后3 d肝功能异常率为96.2%(51/53),明显高于消融范围≤2针者(81.6%,P<0.05)。乙肝表面抗原(HBsAg)、HBV DNA、甲胎蛋白(AFP)阴性与阳性组,是否合并门脉癌栓的不同分组,RFA术后3 d、1个月的肝功能异常率的差异无统计学意义(P﹥0.05)。结论 RFA虽是微创技术,但在短期仍有不同程度的肝损伤。RFA术前应积极评估患者肝功能、术后密切监测肝功能变化,加强保肝治疗。Objective To analyze the effect of radiofrequency ablation （RFA） on liver function in patients with hepatitis B virus （HBV） associated hepatocellular carcinoma （HCC）. Methods Retrospectively analysis was performed of the liver function in 140 patients with HBV-associated HCC before and 3 days and 1 month after RFA. Results The rates of abnormal liver function 3 days and 1 month after RFA were 87.1%（122/140）and 25.7%（36/140）, and the differences were statistically significant （P 〈0.05）. The abnormal liver function rate in 1 month after RFA was 81.8%in Child-Pugh C patients ,which was significant higher than Child-Pugh A and B （P 〈 0.05）. The abnormal rate in 3days after RFA in the needle ablation range≥3 （96.2%）was significant higher than needle ablation range ≤2 （P 〈 0.05）. The abnormal liver function rate was unrelated to HBV replication, AFP value, the presence or absence of portal vein tumor thrombus（PVTT）. Conclusion Though RFA is a minimal invasive technique, liver function injury happens in short term. It is important to evaluate liver function actively before RFA and pay attention to the changes after treatment.

关 键 词：射频消融术 肝细胞癌 乙型肝炎病毒 肝功能 

分 类 号：R735.7[医药卫生—肿瘤]