经皮射频消融术与腹腔镜肝癌切除术治疗小肝癌的临床疗效观察  

Comparison of percutaneous radiofrequency ablation and laparoscopic liver resection in treatment of small hepatocellular carcinoma

作　　者：王细文[1] 王巍威 赵宏智[1] 李靖[1] WANG Xiwen WANG Weiwei ZHAO Hongzhi LI Jing(Department of Hepatobiliary Surgery, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, Chin)

机构地区：[1]第三军医大学新桥医院肝胆外科,重庆400037

出　　处：《西部医学》2017年第2期183-186,共4页Medical Journal of West China

基　　金：国家自然科学基金(30170424)

摘　　要：目的对比经皮射频消融术与腹腔镜肝切除术治疗小肝癌的临床疗效。方法选择2011年1月至2015年12月在我院诊治的126例小肝癌患者,根据治疗方法的不同分为两组,采用腹腔镜肝癌切除术者61例(腹腔镜肝癌切除术组),采用经皮射频消融术者65例(经皮射频消融术组),观察两组预后情况。结果所有患者顺利完成手术,腹腔镜肝癌切除术组无中转开腹情况。经皮射频消融术组完全消融,术后1个月的疼痛、肺部感染、出血、恶心呕吐等并发症发生率(8.3%)低于腹腔镜肝癌切除术组(26.7%)(P<0.05)。两组术后1个月的血清丙氨酸氨基转移酶(ALT)与门冬氨酸氨基转移酶(AST)水平低于术前(P<0.05),同时经皮射频消融术组术后1个月的的血清ALT与AST明显低于腹腔镜肝癌切除术组(P<0.05)。经皮射频消融术组的生存时间与无瘤生存时间分别为(34.21±2.98)月和(27.20±3.11)月均高于腹腔镜肝癌切除术组(28.44±4.19)月和(22.98±3.78)月(P<0.05)。结论相对于腹腔镜肝切除术,经皮射频消融术在小肝癌治疗中的应用成功率高,有利于促进肝功能的恢复,减少术后并发症的发生,从而延长肝细胞癌患者的生存时间。Objective To compare the therapeutic effect of percutaneous radiofrequency ablation and laparoscopic liver resection in treatment of small hepatocellular carcinoma. Methods 126 patients with small hepatocellular carcinoma were selected. According to the different treatment methods, the patients were divided into laparoscopic liver resection group （61 cases） and percutaneous radiofrequency ablation group （65 cases）. The outcome was observed. Results The surgery of all patients were successfully completed. There were no laparotomy in the laparoscopic liver resection group and there were complete ablation in the percutaneous radiofrequency ablation group. The pain, pulmonary infection, bleeding, nausea, vomiting and other complications （8.3 %） in the percutaneous radiofrequency ablation group were significantly less than that of the laparoscopic liver resection group （26.7 %） （P〈0.05）. The serum ALT and AST after operation in the percutaneous radiofrequeney ablation group and the laparoscopic liver resection group were significantly lower than that before operatiori （P〈0. 05）. The serum levels of ALT and AST in the percutaneous radiofrequency abla- tion group were significantly ldwer than those in the laparoscopic liver resection group （P〈0.05）. The survival time and tumor free survival time of the percutaneous radiofrequency ablation group were significantly higher than that in the laparoseopic liver resection group（P〈0.05）. Conclusion Compare to laparoscopie liver resection, percutaneous radiofrequency ablation application in treatment of small hepatocellular carcinoma has high success rate, which can promote the recovery of liver function, reduce the incidence of postoperative complications and extend the survival time of patients.

关 键 词：原发性肝癌 小肝癌 经皮射频消融术 腹腔镜肝癌切除术 肝功能 并发症 术后 

分 类 号：R735.7[医药卫生—肿瘤]