RFA联合LAH术治疗原发性肝癌并门静脉癌栓的临床效果分析  

Clinical effect analysis of RFA combined with LAH in the treatment of primary liver cancer with portal vein cancer embolus

作　　者：林巧 周丽 Lin Qiao;Zhou Li(Operating Room of Inpatient Department,the Third People’s Hospital of Chengdu,Chengdu Sichuan Province 610014,China)

机构地区：[1]成都市第三人民医院住院部手术室,成都610014

出　　处：《中华普外科手术学杂志（电子版）》2024年第5期521-524,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省科技计划项目(2021YFS0082)。

摘　　要：目的:探究射频消融术(RFA)联合腹腔镜解剖性半肝切除术(LAH)治疗原发性肝癌(PLC)并门静脉癌栓(PVTT)的临床效果。方法:回顾性分析2018年6月至2019年6月收治125例PLC并PVTT患者的临床资料,按照手术方法分为观察组(n=73,RFA联合LAH治疗)、对照组(n=52,RFA治疗)。比较两组患者近期临床疗效、围手术期指标(手术时间、术中出血量、住院时间);术后12h、24h、48h、72h疼痛程度[视觉模拟评分(VAS)];记录术前及术后7d肝功能指标;比较两组患者术后并发症及复发情况。统计分析用SPSS 24.0软件处理,计量资料以(x±s)形式呈现,采用t检验;计数资料以[例(%)]表示,临床相关差异通过卡方检验进行评估,等级资料以[例(%)]表示,进行Z检验,P<0.05为差异有统计学意义。结果:两组患者近期临床疗效无统计学意义(P>0.05);观察组患者术中出血量、住院时间均明显低于对照组(P<0.05),两组手术时间无统计学意义(P>0.05);术后12h、24h、48h、72h观察组VAS评分明显低于对照组(P<0.05);术后7d,两组患者肝功能指标水平明显低于术前,观察组明显低于对照组(P<0.05);两组患者并发症发生率无统计学意义(P>0.05),观察组患者复发率低于对照组(P<0.05)。结论:LAH术中辅助性用RFA治疗原发性肝癌并门静脉癌栓具有良好疗效。Objective:To investigate the clinical effect of radiofrequency ablation(RFA)combined with laparoscopic anatomic hemihepatectomy(LAH)in the treatment of primary liver cancer(PLC)with portal vein cancer thrombus(PVTT).Methods:The clinical data of 125 PLC patients with PVTT treated from June 2018 to June 2019 were retrospectively analyzed,and they were divided into observation group(n=73,RFA combined with LAH)and control group(n=52,RFA treatment)according to the surgical method.The short-term clinical efficacy and perioperative indexes(operation time,intraoperative blood loss,length of hospital stay)were compared between the two groups.Pain level at 12h,24h,48h,72h after surgery[visual analogue scale(VAS)];Liver function indexes were recorded before and 7 days after operation.Complications and recurrence were compared between the two groups.Statistical analysis was processed by SPSS 24.0 software,and measurement data were presented in the form of(x±s),and t test was adopted.Count data were represented by[cases(%)],clinically relevant differences were evaluated by Chi-square test,and grade data were represented by[cases(%)],and Z test was performed.P<0.05 was considered statistically significant.Results:There was no statistical significance in the short-term clinical effect between the two groups(P>0.05).The intraoperative blood loss and hospital stay in the observation group were significantly lower than those in the control group(P<0.05),and there was no statistical significance in the operation time between the two groups(P>0.05).VAS scores in observation group were significantly lower than control group at 12h,24h,48h and 72h after operation(P<0.05).On the 7th day after operation,the level of liver function indexes in two groups was significantly lower than before operation,and the observation group was significantly lower than the control group(P<0.05).There was no statistical significance in the incidence of complications between the two groups(P>0.05),and the recurrence rate of observation group was lower tha

关 键 词：原发性肝癌 门静脉癌栓 腹腔镜解剖性半肝切除术 射频消融 

分 类 号：R735.7[医药卫生—肿瘤]