肝动脉化疗栓塞术联合腹腔镜下射频消融术与单纯腹腔镜下射频消融术治疗小肝癌的疗效比较  

Efficacy of TACE combined with LRFA and LRFA alone in treatment for small hepatocellular carcinoma

作　　者：王冰[1,2] 贾佳[2] 张绍庚[1] 余灵祥[1] 王继涛[2] 乐羿[1] 孙百军[1] 

机构地区：[1]解放军第302医院肝胆外科一中心,北京100039 [2]河北北方学院研究生部,河北张家口075000

出　　处：《解放军医学院学报》2016年第1期1-4,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨肝动脉化疗栓塞术（transarterial chemoembolization,TACE）联合腹腔镜下射频消融（laparoscopic radiofrenquency ablation,LRFA）与单纯LRFA治疗小肝癌的疗效。方法回顾性分析解放军第302医院2010年7月-2011年9月经确诊为肝癌的66例临床资料,按照治疗手段不同分为LRFA组（n=34）和TACE＋LRFA组（n=32）,比较两组术后肿瘤1年复发率、总生存率及无瘤生存率。结果 LRFA组肿瘤1年复发率、术后1年、2年、3年生存率、术后1年、2年、3年无瘤生存率分别为67.65%、79.41%、52.94%、41.18%、70.59%、41.17%、35.29%,而联合治疗组分别为37.50%、90.63%、78.13%、56.25%、81.25%、59.38%、53.13%,两组以上指标差异均有统计学意义（P=0.000~0.033）。两组患者术后主要不良反应有发热、局部疼痛、一过性肝功损害、恶心和呕吐等,其发生率两组差异均无统计学意义。结论 TACE联合LRFA治疗肝癌的疗效明显优于单纯LRFA。Objective To investigate the efficacy of transarterial chemoembolization（TACE） plus laparoscopic radiofrenquency ablation（LRFA） in treatment of small hepatocellular carcinoma（HCC） in comparison with LRFA alone. Methods Clinical data about 66 cases diagnosed as HCC were retrospectively analyzed in 302 Military Hospital of PLA from July 2010 to September 2011. According to the different treatment methods, patients were divided into LRFA alone group（n=34） and TACE plus LRFA group（n=32）. Recurrence rate of tumor after one year of operation, overall survival and recurrence-free survival of two different treatment modalities were compared. Results Tumor recurrence rate of 1 year, postoperative survival rate of 1-, 2-, and 3-year and postoperative recurrence-free survival rate of 1-, 2-, and 3-year for LRFA alone group was 67.65%, 79.41%, 52.94%, 41.18%, 70.59%, 41.17%, 35.29%, respectively. The combined group was 37.50%, 90.63%, 78.13%, 56.25%, 81.25%, 59.38%, 53.13%, respectively, the difference between the two groups was statistically significant（P=0.000-0.033）. The postoperative adverse reactions of patients in two groups were fever, local pain, liver function damage, nausea and vomiting, the occurrence rate between two groups were not statistically significant. Conclusion The efficacy of TACE plus LRFA in treatment of HCC is significantly better than LRFA alone.

关 键 词：小肝癌 肝动脉化疗栓塞术 射频消融术 腹腔镜 生存率 

分 类 号：R657.4[医药卫生—外科学]