射频消融术和手术治疗原发性肝癌对照分析  

Clinical Analysis of the Radiofrequency Ablation for Primary Hepatic Carcinoma

作　　者：刘江伟[1] 黄建钊[1] 孙倩[2] 刘延[1] 柳严[1] 赵鹏伟[1] 田利[1] 王欧[1] 李强[1] 

机构地区：[1]贵州省人民医院肝胆外科 [2]贵州省人民医院超声科

出　　处：《中国医学计算机成像杂志》2016年第5期444-450,共7页Chinese Computed Medical Imaging

摘　　要：目的：研究射频消融术治疗原发性肝细胞癌的临床疗效及并发症发生情况。方法：通过回顾性分析贵州省人民医院肝胆外科在2008年3月至2013年3月间61例病理明确诊断为原发性肝细胞癌并行射频消融术患者的临床资料,统计患者术后1年、2年和3年生存率,观察患者术后疼痛、发热、腹腔出血、感染和胸腔积液等术后并发症的发生情况。与同期55例行手术切除的原发性肝癌病例进行对照研究,分析二组患者术后生存时间,术后1年、2年和3年生存率的差异,比较二组患者术后并发症的发生情况。结果：术后生存率情况,射频消融组术后1年、2年和3年生存率分别为77.1%、62.3%和45.9%。各亚组之间,在肿瘤大小〈3cm组,1年、2年和3年生存率分别为94.7%、84.2%和68.4%。在肿瘤大小3～5cm组,1年、2年和3年生存率分别为87.0%、65.2%和52.2%。在肿瘤大小5～10cm组,1年、2年和3年生存率分别为61.5%、53.8%和23.1%。在肿瘤大小〉10cm组,1年、2年和3年生存率分别为16.7%、0.0%和0.0%,生存曲线经Log-Rank检验发现,肿瘤大小〈3cm组和3～5cm组术后生存时间总体均明显长于5～10cm组,差异具有统计学意义（P〈0.05）。术后并发症情况,61例患者中,29例术后需止痛处理,33例术后出现发热,1例出现腹腔内出血,1例出现肺部感染,1例出现胸腔积液。与肝切除术患者比较,随访结果进行单因素的预后分析,射频消融组与手术切除组术后生存率相近,生存曲线经Log-Rank检验发现,差异没有统计学意义（P〉0.05）。进一步在各亚组之间分析表明,肿瘤大小〈3cm、3～5cm和肿瘤大小〉10cm组,射频消融和手术切除术后生存时间没有明显的差别,差异没有统计学意义（P〉0.05）,在肿瘤大小5～10cm组,手术切除组术后生存时间总体明显长于射频消融组,生存曲线经Log-Rank检验发现,差异具有统计学意义（χ2=8.341,P=0.03）。术后并发症情况,Purpose： To study the clinical effect and complications of radiofrequency ablation （RFA） for primary hepatic carcinoma. Methods： The clinical data of 61 cases of primary hepatocellular carcinoma （HCC） treated by radiofrequency ablation between March 2008 and March 2013 in Department of hepatobiliary surgery of Guizhou People＇s Hospital were retrospectively analyzed. All cases were diagnosed with pathological results. The survival rate of 1 years, 2 years and 3 years after operation was calculated. Postoperative complications such as pain, fever, abdominal bleeding, infection and pleural effusion were observed. These data were compared with 55 cases of HCC treated by hepatic resection （RES） in the same period. Results： The 1 years, 2 years and 3 years survival rates were 77.1%, 62.3%, and 45.9 % in the RFA group. In the tumor size 〈3cm group, the 1 years, 2 years and 3 years survival rates were 94.7 %, 84.2%, and 68.4 %. In the tumor size 3-5cm group, the 1 years, 2 years and 3 years survival rates were 87.0 %, 65.2%, and 52.2%. In the tumor size 5-10cm group, the 1 years, 2 years and 3 years survival rates were 61.5 %, 53.8%, and 23.1%. In the tumor size 〉10cm group, the 1 years, 2 years and 3 years survival rates were 16.7 %, 0.0%, and 0.0 %. The Log-Rank test of the survival curves showed that in the tumor size 〈3cm group, the survival time was significantly longer than that in the tumor size 3-5cm group （P〈0.05）. For the postoperative complications, 29 cases of RAF group need pain relieving treatment after operation, 33 cases were with postoperative fever, 1 case occurred abdominal bleeding, 1 case occurred pulmonary infection, and 1 case occurred pleural effusion. Compared with cases of HCC treated by hepatic resection （RES）, the survival rate of the radiofrequency ablation group was similar to that of the surgical resection group, and the survival curve was with no statistical significant difference by Log-Rank test （P〉0.05）. The Log-Rank test of survival curves show

关 键 词：射频消融 肝切除术 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤]