肝动脉栓塞化学治疗联合射频消融与再次手术切除治疗原发性肝癌术后复发的疗效比较  

Comparison of the efficacy of combination of transcatheter arterial chemoembolization and radio frequency ablation and re-operation on postoperative recurrent primary carcinoma of liver

作　　者：张辉[1] 徐新保[1] 何晓军[1] 刘承利[1] 张洪义[1] 

机构地区：[1]中国人民解放军空军总医院肝胆外科,北京100142

出　　处：《新乡医学院学报》2014年第11期928-930,共3页Journal of Xinxiang Medical University

摘　　要：目的比较肝动脉栓塞化学治疗联合射频消融(TACE+RFA)与再次手术切除治疗原发性肝癌切除术后复发的疗效。方法回顾性分析中国人民解放军空军总医院确诊原发性肝癌行肝癌根治性切除术后、有肝内复发而无肝外转移的患者159例,其中行TACE+RFA治疗者(TACE+RFA组)87例,行再次手术切除治疗者(再手术组)72例,2组患者中均不包括肝功能Child C级患者。TACE+RFA组中最大肿瘤直径为4.5 cm,平均2.1 cm;再手术组中最大肿瘤直径为5.5 cm,平均3.5 cm。结果 TACE+RFA组患者均未出现严重并发症,而再手术组中1例死于术后肝衰竭,8例出现肝功能失代偿。TACE+RFA组和再手术组的1、2、3 a生存率分别为75.8%(66/87)、63.2%(55/87)、51.7%(45/87)和69.4%(50/72)、58.3%(42/72)、47.2%(34/72),差异均无统计学意义(P>0.05)。结论对于原发性肝癌术后复发患者,TACE+RFA与再次手术切除治疗相比,其疗效及预后相近,但TACE+RFA适应证更宽,术后出现肝衰竭的概率低,术后肝功能损害恢复快。Objective To compare the efficacy of combination of transcatheter arterial chemoembolization and radio frenquency ablation（TACE ＋ RFA） and re-operation on the treatment of postoperative recurrent primary carcinoma of liver.Methods A total of 159 post radical operation patients with primary carcinoma of liver were analyzed retrospectively,excluding those with extrahepatic metastasis or Child C liver function. Of those patients,87 cases were treated with TACE ＋ RFA therapy（TACE ＋ RFA group）,while the other 72 cases were applied with recurrency excision（re-operation group）. In TACE ＋RFA group,the average size of recurrent lesions was 2. 1 cm in diameter,in which the maximal size of tumor was 4. 5 cm in diameter. In the re-operation group,the average size of recurrent lesions was 3. 5 cm in diameter,in which the maximal size of tumor was 5. 5 cm in diameter. Results No severe complication was observed in TACE ＋ RFA group,while 1 case was succumb to hepatic failure and 8 cases had liver function decompensation in re-operation group. The 1-year,2-year and 3-year survival rates were 75. 8%（66 /87）,63. 2%（55 /87） and 51. 7%（45 /87） in TACE ＋ RFA group,which were 69. 4%（50 /72）,58. 3%（42 /72） and 47. 2%（34 /72） in re-operaion group,respectively,and the difference between them was not significant（P〉0.05）. Conclusion There is no difference of therapeutic effect and prognosis between TACE ＋ RFA and re-operation treatment in primary carcinoma of liver patients. TACE ＋ RFA treatment can acquire less incidence of hepatic failure and better recovery of hepatic function,with wider range of application.

关 键 词：原发性肝癌 栓塞化学治疗 射频消融 再手术 复发 

分 类 号：R965[医药卫生—药理学]