再次肝切除术和射频消融术在治疗肝切除术后早期复发性小肝癌中的疗效比较  

Comparison of efficacy of rehepatectomy and radiofrequency ablation in treatment of early recurrent small liver cancer after hepatectomy

作　　者：卢冰[1] LU Bing(Department of Hepatobiliary Pancreas Surgery,Henan Provincial Peoples Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院肝胆胰腺外科,郑州450003

出　　处：《医药论坛杂志》2024年第6期620-623,628,共5页Journal of Medical Forum

摘　　要：目的研究肝切除术后(recurrent hepatocellular carcinoma,rHCC)患者采用再次肝切除术(liver resection,LR)和射频消融术(radiofrequency ablation,RFA)的临床疗效。方法选取2018年1月—2021年1月河南省人民医院肝胆胰腺外科收治的rHCC患者116例,按治疗方法不同,将采取RFA治疗的68例设为试验组,将采取LR治疗的48例设为对照组。对两组治疗情况进行评估、肿瘤标志物水平和血清肝功能指标进行检测、术后并发症进行观察、生存及复发情况进行记录。结果两组手术治疗情况对比,试验组手术时间、术中失血量及术后住院时间分别为(31.28±31.99)min、(25.14±2.16)mL及(4.59±1.61)d,均低于对照组,差异有统计学意义(P<0.05);术前两组甲胎蛋白(Alpha-Fetal Protein,AFP)、癌胚抗原(carcinoembryonic antigen,CEA)水平比较无统计学意义(P>0.05),术后均降低,同组间与术前比较差异有统计学意义(P<0.05),但术后组间比较无统计学意义(P>0.05);术前两组总胆红素(total bilirubin,TBil,TBIL)、谷草转氨酶(Aspartate aminotransferase,AST)和谷丙转氨酶(alanine aminotransferase,ALT)水平比较无统计学意义(P>0.05),试验组术后TBIL(17.46±5.20)μmol/L,低于对照组,AST和ALTA水平分别为(39.25±5.84)U/L及(37.30±7.72)U/L,均高于对照组(P<0.05);试验组并发症发生率20.58%,低于对照组的45.83%,差异有统计学意义(P<0.05);两组生存和复发情况对比,差异无统计学意义(P>0.05)。结论和LR对比,RFA治疗rHCC手术时间更短、恢复更快且并发症更少,同等情况下,可优先选择。Objective To investigate the clinical efficacy of re-hepatectomy(LR)and radiofrequency ablation(RFA)in patients with early recurrent small liver cancer(rHCC)after hepatectomy.Methods A total of 116 patients with early rsHCC admitted to the Department of Hepatobiliary and Pancreatic Surgery from January 2018 to January 2021 were selected.According to different treatment methods,68 patients treated with RFA were selected as the experimental group,and 48 patients treated with LR were selected as the control group.The treatment status of the two groups was evaluated,the level of tumor markers and serum liver function indexes were detected,postoperative complications were observed,survival and recurrence were recorded.Results The operation time,intraoperative blood loss and postoperative hospital stay of the experimental group were(31.28±31.99)min,(25.14±2.16)mL and(4.59±1.61)d,respectively,which were lower than those of the control group,and the difference was statistically significant(P<0.05).The levels of Alpha-Fetal Protein(AFP)and carcinoembryonic antigen(CEA)were not statistically significant between the two groups before surgery(P>0.05),but decreased after surgery,with statistically significant differences between the same group and before surgery(P<0.05).However,there was no statistical significance between the postoperative groups(P>0.05).total bilirubin(TBil,TBil),Aspartate aminotransferase(AST)and alanine aminotransferase(AST)in two groups before surgery There was no statistical significance in ALT level(P>0.05).TBIL(17.46±5.20)μmol/L in experimental group was lower than that in control group,AST and ALTA levels were(39.25±5.84)U/L and(37.30±7.72)U/L,respectively,which were higher than those in control group(P<0.05).The complication rate of test group was 20.58%lower than that of control group(45.83%),the difference was statistically significant(P<0.05).There was no significant difference in survival and recurrence between the two groups(P>0.05).Conclusion Compared with LR,RFA treatment of rHCC has s

关 键 词：射频消融术 复发性小肝癌 再次肝切除 

分 类 号：R657.3[医药卫生—外科学]