腹腔镜下微波消融治疗肝脏局灶性结节性增生的疗效  

Efficacy of laparoscopic microwave ablation for the treatment of focal nodular hyperplasia

作　　者：许超 冯彦植 韩国勇 吴金道 孔连宝 XU Chao;FENG Yanzhi;HAN Guoyong;WU Jindao;KONG Lianbao(Hepatobiliary Center,the First Affiliated Hospital of Nanjing Medical University,Key Laboratory of Liver Transplantation Center,NHC Key Laboratory of Hepatobiliary Cancers,Chinese Academy of Medical Sciences,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院肝胆中心,中国医学科学院肝移植重点实验室,国家卫生健康委员会肝胆管癌重点实验室,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2024年第11期1581-1585,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金面上项目(81972768)。

摘　　要：目的:评估腹腔镜微波消融技术治疗肝脏局灶性结节性增生(focal nodular hyperplasia,FNH)的疗效与安全性。方法:回顾性分析2019年11月—2024年3月于南京医科大学第一附属医院肝胆中心接受治疗的FNH患者资料,其中43例接受腹腔镜微波消融治疗(消融组),65例接受外科切除治疗(切除组),对比两组患者手术时长、术中出血量、术后住院时间、费用以及术后并发症等关键指标。结果:消融组患者的手术均成功完成,平均手术时间为(1.1±0.6)h,术中平均出血量为(35.8±6.7)mL,术后平均住院时间为(2.9±1.5)d,平均住院费用为(21257.5±3059.2)元,这些指标均显著优于切除组。术后并发症包括发热(4例,占9.3%)、血尿(1例,占2.3%)和肾功能不全(血肌酐水平236μmol/L,1例,占2.3%)。术后并发症的发生率与切除组相比差异无统计学意义。随访结果表明,所有患者的病灶均获得完全消融,且在1年的随访期内,未发现病灶增大或复发。结论:腹腔镜微波消融治疗FNH安全、有效且经济,值得在临床上进一步推广和应用。Objective:To evaluate the efficacy and safety of laparoscopic microwave ablation for treating focal nodular hyperplasia(FNH)of the liver.Methods:A retrospective analysis was conducted on FNH patients treated at our center from November 2019 to March 2024.The subjects included 43 patients underwent laparoscopic microwave ablation(ablation group)and 65 patients received surgical resection(resection group).Key indicators such as operation duration,intraoperative blood loss,postoperative hospital stay,costs,and postoperative complications were compared between the two groups.Results:All procedures in the ablation group were successfully completed,with an average operation duration of(1.1±0.6)h,average intraoperative blood loss of(35.8±6.7)mL,average postoperative hospital stay of(2.9±1.5)d,and average hospitalization costs of(21257.5±3059.2)yuan.These indicators were significantly better than those of the resection group.Postoperative complications included fever(4 cases,9.3%),hematuria(1 case,2.3%),and renal insufficiency(1 case with a serum creatinine level of 236μmol/L,2.3%).The incidence of postoperative complications showed no significant difference compared to the resection group.Follow-up results indicated that all lesions were completely ablated,with no lesion enlargement or recurrence observed within one-year follow-up period.Conclusion:Laparoscopic microwave ablation for FNH is safe,effective,and economical,and it merits clinical promotion and application.

关 键 词：肝肿物 局灶性结节性增生 腹腔镜 微波消融 

分 类 号：R735.7[医药卫生—肿瘤]