彩超引导下多针组合射频消融术与开腹手术切除术对肝脏巨大血管瘤的治疗疗效对比研究  

A Comparative Study of Efficacy of Color Doppler Ultrasound-guided Multi-hook Radiofrequency Ablation and Open Laparotomy in the Treatment of Giant Hepatic Hemangioma

作　　者：陈菲 CHEN Fei(Henan Jiaozuo Coal Industry Group Co,LTD Central Hospital,Jiaozuo,454150)

机构地区：[1]河南省焦作煤业(集团)有限责任公司中央医院,454150

出　　处：《实用癌症杂志》2022年第9期1508-1511,1515,共5页The Practical Journal of Cancer

摘　　要：目的探究分别应用彩超引导下多针组合射频消融术(RFA)与开腹肝切除术(OH)治疗巨大肝脏血管瘤(GHH)的临床疗效。方法选取GHH患者62例,随机分为RFA组(n=31)与OH组(n=31)。术前采用超声造影观察两组患者肿瘤直径,RFA组5~10 cm患者28例、>10 cm患者3例,OH组5~10 cm患者26例、>10 cm患者5例。RFA组给予彩超引导下多针组合RFA治疗,OH组给予传统开腹手术切除治疗。观察不同肿瘤直径两组患者术中出血量、输血例数及输血量,手术时间及住院时间,并发症发生率、病灶一次性坏死率及二次手术率,术前、术后1个月及术后6个月肿瘤直径。结果肿瘤直径5~10 cm患者中,RFA组术中出血量、输血比例及输血量均明显低于OH组,且手术时间及住院时间短于OH组(P<0.05);RFA组并发症发生率[14.28%(4/28)]低于OH组[19.23%(5/26)](P<0.05);RFA组病灶一次性坏死率[96.43%(27/28)]与OH组[100%(26/26)]比较无明显差异(P>0.05);RFA组二次手术率[10.71%(3/28)]低于OH组[23.08%(6/26)](P<0.05);术后1个月及术后6个月两组肿瘤直径比较无显著差异(P>0.05);术后1个月及术后6个月两组肿瘤直径均明显小于本组术前(P<0.05)。肿瘤直径>10 cm患者中,术后1个月及术后6个月两组肿瘤直径比较均无明显差异(P>0.05);术后1个月及术后6个月两组肿瘤直径均分别小于本组术前(P<0.05);OH组病灶一次性坏死率[80.00%(4/5)]优于RFA组[33.33%(1/3)](P<0.05);RFA组二次手术率[66.67%(2/3)]高于OH组[20.00%(1/5)](P<0.05)。结论彩超引导下多针组合RFA能明显减少术中出血量、降低并发症发生率,减轻患者痛苦,可适用于治疗临床肿瘤直径5~10 cm GHH患者。OH法在手术切除直径>10 cm血管瘤时较彻底,临床治疗肿瘤直径>10 cm的GHH患者更有优势。Objective To investigate the clinical efficacy of color Doppler ultrasound-guided multi-hook radiofrequency ablation(RFA)and open hepatectomy(OH)in the treatment of giant hepatic hemangioma(GHH).Methods 62 GHH patients were selected,and randomly divided into RFA group(n=31)and OH group(n=31).Preoperative contrast-enhanced ultrasound was used to observe the tumor diameters in the 2 groups.RFA group included 28 patients with tumor diameters ranging from 5 to 10 cm and 3 patients with tumor diameters larger than 10 cm.OH group included 26 patients with tumor diameters ranging from 5 to 10 cm and 5 patients with tumor diameters larger than 10 cm.The RFA group was treated with color Doppler ultrasound-guided multi-hook radiofrequency ablation,meanwhile,the OH group was treated with traditional open laparotomy.Intraoperative blood loss,blood transfusion ratio,blood transfusion volume,operation time,hospital stay,complication rate,primary necrosis rate and secondary operation rate,and tumor diameter were observed in the 2 groups with different tumor diameters.Results Among patients with tumor diameter of 5-10 cm,the intraoperative blood loss,blood transfusion ratio and blood transfusion volume in the RFA group were significantly lower than those in the OH group,and the operation time and hospitalization time were shorter than those in the OH group(P<0.05).The incidence of complications in the RFA group was lower than that in the OH group[14.28%(4/28)vs.19.23%(5/26),P<0.05].The primary necrosis rate in RFA group was higher than that in OH group[96.43%(27/28)vs.100%(26/26),P>0.05].The secondary operation rate in RFA group was lower than that in OH group[10.71%(3/28)vs.23.08%(6/26),P<0.05].Tumor diameter at postoperative 1 mon and 6 mon showed no difference(P>0.05).Tumor diameter at postoperative 1mon and 6mon were decreased in both groups compared with those before operation(P<0.05).In patients with tumor diameter>10 cm,there was no significant difference in tumor diameter at postoperative 1mon and 6mon(P>0.05);Tumor diam

关 键 词：彩超引导 多针组合射频消融术 开腹手术切除 肝脏巨大血管瘤 

分 类 号：R735.7[医药卫生—肿瘤]