超声引导下射频消融术在小肝癌临床治疗中的可行性研究  

Feasibility study of ultrasound-guided radiofrequency ablation in the clinical treatment of small liver cancer

作　　者：王谨 崔海峡[1] 颜秉辉 Wang Jin;Cui Haixia;Yan Binghui(Department of Ultrasound Medicine,Sanmenxia Central Hospital,Henan 472000,China)

机构地区：[1]河南省三门峡市中心医院超声医学科,472000

出　　处：《实用医学影像杂志》2025年第1期62-66,共5页Journal of Practical Medical Imaging

摘　　要：目的 探讨超声引导下射频消融术(RFA)在小肝癌临床治疗中的可行性。方法 以2019年5月至2021年5月经本院收治小肝癌患者85例作回顾性研究,按术式差异分作肝部分切除术组(40例)及RFA组(45例),比较2组疗效、康复指标、肝功能及肿瘤标志物及预后。结果 2组客观缓解率、疾病控制率比较,差异无统计学意义(P>0.05);RFA组手术时间、住院时间短于肝部分切除术组,术中出血量少于肝部分切除术组(P<0.05);经治疗,2组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)均有所上升,甲胎蛋白(AFP)有所下降,RFA组ALT、AST、TBIL低于肝部分切除术组(P<0.05),但2组AFP比较,差异无统计学意义(P>0.05);RFA组并发症发生率为7%,低于肝部分切除术组的22%(P<0.05),2组1年、3年总生存时间(OS)率比较,差异无统计学意义(P>0.05)。结论 相比于肝部分切除术,超声引导下RFA用于小肝癌治疗近期疗效及远期预后相当,但在减少肝功能损伤,利于康复及降低并发症发生方面具有一定优势。Objective To explore the feasibility of ultrasound-guided radiofrequency ablation(RFA)in the clinical treatment of small hepatocellular carcinoma.Methods A retrospective study was conducted on 85 patients with small liver cancer who were treated in our hospital from May 2019 to May 2021.According to the difference in surgical methods,they were divided into two groups:partial hepatectomy group(n=40 cases)and RFA group(n=45 cases).The efficacy,rehabilitation indicators,liver function,tumor markers and prognosis of the two groups were compared.Results There was no significant difference in objective response rate(ORR)and disease control rate(DCR)between the two groups(P>0.05).The operation time and hospital stay in the RFA group were shorter than those in the partial hepatectomy group,and the amount of intraoperative bleeding was less than that in the partial hepatectomy group(P<0.05).After treatment,ALT,AST,and TBIL in the two groups increased,while alpha-fetoprotein(AFP)decreased.ALT,AST,and TBIL in the RFA group were lower than those in the partial hepatectomy group(P<0.05),but there was no significant difference between the two groups in AFP(P>0.05).The complication rate in the RFA group was 7%,which was lower than that in the partial hepatectomy group(22%,P<0.05).There was no significant difference in the 1-year and 3-year OS rates between the two groups(P>0.05).Conclusion Compared with partial hepatectomy,the short-term efficacy and long-term prognosis of ultrasound-guided RFA in the treatment of small hepatocellular carcinoma are similar,but it has certain advantages in reducing liver function damage,facilitating rehabilitation,and reducing complications.

关 键 词：肝肿瘤 射频消融术 肝切除术 肝功能 

分 类 号：R73[医药卫生—肿瘤]