二次切除手术与经皮射频消融治疗切除后复发性肝细胞肝癌的临床疗效和预后分析  

Clinical effects and prognostic analysis of secondary resection operation and percutaneous RFA in treating recurrent HCC post-resection

作　　者：李春丽[1] 董巧云[2] 侯丽 伊生勇[3] 尚翠萍[4] 谢欢[2] LI Chun-li;DONG Qiao-yun;HOU Li(Day Care Ward,Bayannur Hospital,Bayannur 015000,China)

机构地区：[1]巴彦淖尔市医院日间病房,内蒙古巴彦淖尔015000 [2]巴彦淖尔市医院消化科,内蒙古巴彦淖尔015000 [3]巴彦淖尔市医院医学影像科,内蒙古巴彦淖尔015000 [4]巴彦淖尔市医院检验科,内蒙古巴彦淖尔015000

出　　处：《中国医学装备》2019年第12期47-51,共5页China Medical Equipment

基　　金：内蒙古自治区自然科学基金(2017MS0631)“二次切除手术与经皮射频消融治疗切除术后复发性肝细胞肝癌的临床疗效和预后分析”

摘　　要：目的:探讨术后复发性肝细胞肝癌(HCC)采用经皮射频消融(RFA)和二次切除手术治疗的疗效和患者预后。方法:回顾性选取医院接收的68例复发性HCC患者,按照治疗措施的不同将其分为消融组和二次手术组,每组34例。消融组采用RFA治疗,二次手术组采用二次切除手术治疗,观察对比两组患者的总体生存率、住院时间、无瘤生存率、并发症发生率及复发率的情况。结果:消融组住院时间(5.5±1.5)d,显著短于二次手术组(14.2±3.2)d,其差异有统计学意义(t=14.354,P<0.05);两组总体生存时间比较,差异无统计学意义;治疗后消融组技术成功率为100%(34/34),二次手术组技术成功率为97.1%(32/33),差异无统计学意义;消融组并发症发生率低于二次切除组,其差异有统计学意义(x2=4.66,P<0.05),但其术后一年局部肿瘤进展率显著高于二次切除组(x2=4.836,P<0.05),两组患者复发率比较差异无统计学意义;两组术后总体生存率比较,差异无统计学意义;消融组术后平均无瘤生存时间为23.55个月,二次手术组为33个月,两组比较差异具有统计学意义(x2=8.779,P<0.05)。结论:RFA和二次切除手术均是复发性肝癌的有效治疗方式,RFA治疗与二次切除手术比较,安全性更高,总体生存时间相当。在条件可行的情况下,RFA术可作为首选治疗方式。Objective:To investigate the curative effects and prognosis of patients when percutaneous radiofrequency ablation(RFA)and secondary resection operation were adopted to treat recurrent hepatocellular carcinoma(HCC)post operation.Methods:Sixty-eight patients with recurrent HCC received treatment in hospital were retrospectively selected and they were divided into ablation group that applied RFA(n=34)and secondary surgery group that applied secondary resection operation(n=34)according to the different treatment measures.And the total survival rate,length of hospital stay,tumor-free survival rate,complication rate and recurrence rate of the two groups were observed and compared.Results:The length of hospital stay of ablation group(5.5±1.5 days)was significantly shorter than that of secondary surgery group(14.2±3.2 days)(t=14.354,P<0.05).The difference of total survival time between two groups was no significant.The difference of technical success rate post treatment between ablation group(100%,34/34)and second surgery group(97.1%,32/33)was no significant.The incidence of complications of ablation group was significantly lower than that of second resection group(x2=4.66,P<0.05),but the local tumor progression rate at 1 year post operation of ablation group was significantly higher than that of second resection group(x2=4.836,P<0.05).And the difference of recurrent rate between two groups was no significant.And the difference of total survival rate post surgery between two groups was no significant.The difference of average tumor-free survival time post surgery between ablation group(23.55 months)and secondary resection group(33 months)was significant(x2=8.779,P<0.05).Conclusion:Both RFA and secondary resection are effective treatments for recurrent HCC.Compared with the latter,RFA is safer.And the total survival times of them are comparable.Therefore,ablation can be the first choice of therapy method when the conditions are feasible.

关 键 词：射频消融(RFA) 复发性肝细胞癌(HCC) 二次切除手术 

分 类 号：R735.7[医药卫生—肿瘤]