CT-RFA与L-RFA治疗膈顶部小肝癌的对比研究  

A comparative study of CT-RFA and L-RFA in the treatment of small hepatocellular carcinoma

作　　者：沈娟[1] 杜超[1] 朱传东[2] 丁怀银[1] SHEN Juan;DU Chao;ZHU Chuandong;DING Huaiyin(Department of Oncology,the Second Hospital of Nanjing,Southeast University, Nanjing 210003,China;Department of Radiology,the Second Hospital of Nanjing,Southeast University, Nanjing 210003,China)

机构地区：[1]东南大学附属第二医院放射科,江苏南京210003 [2]东南大学附属第二医院肿瘤科,江苏南京210003

出　　处：《现代医学》2018年第11期1222-1226,共5页Modern Medical Journal

摘　　要：目的:探讨CT引导下射频消融(CT-FRA)与腹腔镜下射频消融(L-RFA)治疗膈顶部复发性小肝癌的安全性、有效性以及两者费用差异。方法:根据治疗方案,将116例局部复发性肝癌患者分为CT-FRA组和L-RFA组,比较两组术中并发症、总生存时间、局部控制率、术后并发症、住院时间、住院费用。结果:两组在5年生存率(36. 7%vs 44. 6%,P=0. 428 9)以及5年疾病控制率(73. 3%vs 67. 9%,P=0. 889 7)方面差异无统计学意义;但与L-RFA组相比,CT-FRA组的住院时间更短(2. 8 d vs 4. 1 d,P <0. 000 1)、住院费用更少(19 217. 6元vs 25 553. 6元,P <0. 000 1)。结论:对于膈顶部复发性小肝癌,CT-RFA和L-RFA都是有效的治疗手段,但CT-RFA相对简便且更经济。Objective:Computed tomography-guided radiofrequency ablation (CT-RFA)and laparoscopic RFA (L-RFA)have been used to treat intrahepatic recurrent small hepatocellular carcinoma (HCC)abutting the diaphragmatic dome.However,the therapeutic safety,efficacy,and hospital expense have never been compared between the two techniques due to the scarcity of the cases.Methods:In this retrospective study,116 patients were divided into two groups with a total of 151 local recurrent HCC lesions abutting the diaphragm.We compared overall survival (OS),local tumor progression (LTP),postoperative complications,and hospital stay and expense between the two groups.Results:Our findings revealed no significant differences in 5-year OS (36.7% vs 44.6%,P = 0.428 9)or 5-year LTP (73.3% vs 67.9%,P = 0.889 7)between CT-RFA and group L-RFA. The overall hospital stay (2.8 days vs 4.1 days,P <0.000 1)and cost (￥19 217.6 vs ￥25 553.6,P<0.000 1) were significantly lower in group CT-RFA in comparison with group L-RFA.Conclusion:CT-RFA is relatively easy and economic for recurrent small HCC abutting the diaphragm,and both CT-RFA and L-RFA are effective techniques.

关 键 词：射频消融 膈顶部 腹腔镜 小肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R730.5[医药卫生—临床医学]