超声引导下射频消融术与手术切除治疗小肝癌患者的对比研究  

Comparative study of ultrasound-guided radiofrequency ablation and surgical resection for patients with small liver cancer

作　　者：李雯[1] 杨柳[1] 牛卫丽 宗红[1] 张艺冰 LI Wen;YANG Liu;NIU Wei-li;ZONG Hong;ZHANG Yi-bing(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,郑州450052

出　　处：《医药论坛杂志》2024年第17期1807-1811,共5页Journal of Medical Forum

基　　金：河南省高等学校重点科研项目计划(23A320003)。

摘　　要：目的观察超声引导下射频消融术与手术切除对小肝癌患者疗心理状态、并发症及复发率的影响。方法纳入郑州大学第一附属医院治疗的小肝癌患者126例,病例选取时间2019年1月—2021年12月,应用随机数字表法分为两组,射频消融组60例患者采取超声引导下经皮穿刺射频消融术治疗,手术切除组66例患者采取外科手术切除,比较两组患者的心理状态、并发症、疗效及术后不同时间的复发率。结果术后,射频消融组SAS评分、SDS评分明显较手术切除组降低[分别为(34.58±3.26)vs(41.84±3.87),(30.06±3.01)vs(41.21±3.58),P<0.05],射频消融组手术时间和住院时间均短于手术切除组[分别为(23.51±3.82)vs(50.12±6.33),(5.24±1.24)vs(10.53±1.58),P<0.05]。射频消融组总缓解率(86.67%)与手术切除组(87.87%)比较差异无统计学意义(P>0.05),射频消融组并发症总发生率(16.67%)明显较手术切除组(34.85%)低,差异有统计学意义(P<0.05)。射频消融组术后半年、1年、2年复发率(分别为5.00%、13.33%、20.00%)略高手术切除组(分别为3.00%、10.61%、15.15%),但组间比较差异无统计学意义(P>0.05)。射频消融组患者术后半年、1年、2年总生存率(分别为96.67%、90.00%、86.67%)与手术切除组(分别为100.00%、93.94%、86.36%)比较差异无统计学意义(P>0.05)。结论超声引导下射频消融治疗效果、术后半年、1年、2年复发率和生存率与手术切除相当,但其在减少并发症、缩短手术时间和住院时间、减轻患者负性心理状态上更具有优势,射频消融治疗可作为治疗小肝癌的主要治疗方法。Objective To observe the effect of ultrasound-guided radiofrequency ablation and surgical resection on the psychological state,complications and recurrence rate of patients with small liver cancer.Methods Totally 126 patients with small liver cancer admitted to the First Affiliated Hospital of Zhengzhou University between January 2019 and December 2021 were included.These patients were divided into the radiofrequency ablation group and the surgical resection group by random number table method.Sixty patients in the radiofrequency ablation group were treated by ultrasus-guided percutaneous radiofrequency ablation,while 66 patients in the surgical resection group were treated by surgical resection.The psychological state,complications,therapeutic effect and recurrence rate between the two groups were compared.Results Compared to the surgical resection group,the SAS and SDS scores in the radiofrequency ablation group were lower afer operation[(34.58±3.26)vs(41.84±3.87),(30.06±3.01)vs(41.21±3.58),respectively,all P<0.05],the operation time and hospital stay in the radiofrequency ablation group were shorter[(23.51±3.82)vs(50.12±6.33),(5.24±1.24)vs(10.53±1.58),respectively,all P<0.05].The total response rate had no significant difference between the two groups(86.67%vs 87.87%,P>0.05).Compared to the surgical resection group,the total complication rate in the radiofrequency ablation group was lower(16.67%vs 34.85%,P<0.05).After 6 months,1 year and 2 years of surgery,compared to the surgical resection group,the recurrence rate in radiofrequency ablation group was slightly higher,but there was no significant difference between the two groups(5.00%vs 3.00%,13.33%vs 10.61%,20.00%vs 15.15%,respectively,all P>0.05).After 6 months,1 year and 2 years of surgery,the overall survival rate had no significant difference between the two groups(96.67%vs 100.00%,90.00%vs 93.94%,86.67%vs 86.36%,respectively,P>0.05).Conclusion The clinical effect,recurrence rate and survival rate after 6 months,1 year and 2 years of surgery of u

关 键 词：小肝癌 射频消融术 手术切除 心理状态 

分 类 号：R735.7[医药卫生—肿瘤]