摘要
目的比较超声引导下射频消融术(radiofrequency ablation, RFA)联合无水乙醇注射、腹腔镜肝切除术治疗小肝癌的效果。方法小肝癌患者97例,其中行超声引导下RFA联合无水乙醇注射治疗49例为射频消融组,行腹腔镜肝切除术治疗48例为腹腔镜组。比较2组手术时间、术中出血量、住院时间、术后7 d并发症发生率,治疗后2个月疾病控制率,术前及术后1个月血清谷丙转氨酶(glutamic pyruvic transaminase, GPT)、谷草转氨酶(glutamic oxaloacetic transaminase, GOT)水平;随访3 a,记录2组1、2、3 a生存率。结果射频消融组手术时间[(54.70±15.44)min]、住院时间[(4.40±0.70)d]较腹腔镜组[(127.60±30.09)min、(6.70±1.41)d]短,术中出血量[(20.60±6.40)mL]较腹腔镜组[(113.20±16.10)mL]少(P<0.05);治疗后2个月,射频消融组疾病控制率(83.67%)与腹腔镜组(87.50%)比较差异无统计学意义(P>0.05);射频消融组术后7 d并发症发生率(8.16%)低于腹腔镜组(22.92%)(P<0.05);射频消融组术后1个月血清GOT[(31.18±4.90)u/L]、GPT[(31.40±10.72)u/L]水平低于腹腔镜组[(48.30±5.06)、(40.50±11.38)u/L](P<0.05),且均低于术前(P<0.05);射频消融组术后1、2、3 a生存率(85.71%、81.63%、67.35%)与腹腔镜组(89.58%、85.42%、68.75%)比较差异无统计学意义(P>0.05)。结论超声引导下RFA联合无水乙醇注射治疗小肝癌可取得与腹腔镜肝切除术相当的效果,且具有并发症发生率低,改善患者肝功能,促进恢复的优势。
Objective To compare the outcome of ultrasound-guided radiofrequency ablation (RFA) combined with anhydrous ethanol injection versus laparoscopic hepatectomy (LH) for small hepatocellular carcinoma (HCC). Methods In 97 patients with small HCC, 49 patients underwent ultrasound-guided RFA combined with anhydrous ethanol injection (RFA group) and 48 patients underwent LH (LH group). The operative time, intraoperative blood loss, hospital stay, incidence of complications on postoperative day 7, disease control rate after two months, and the levels of glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminase (GOT) before and 1 month after operation were compared between two groups. The 1-, 2- and 3-year survival rates were followed up. Results The operative time and hospital stay were significantly shorter in RFA group ((54. 70± 15. 44) min,(4. 40±0. 70) d) than those in LH group ((127. 60±30. 09) min,(6. 70± 1.41) d)(P<0. 05), and the blood loss volume was significantly less in RFA group ((20. 60±6. 40) mL) than that in LH group ((113. 20± 16. 10) mL)(PV0. 05). The disease control rate showed no significant difference between RFA group and LH group (83. 67% vs. 87. 50%) in 2 months after treatment (P>0. 05). The incidence of complications was significantly lower in RFA group (8. 16%) than that in LH group (22. 92%) on the postoperative 7 day (P<0. 05). The levels of serum GOT and GPT were significantly lower in RFA group ((31. 18± 4.90),(31. 40±10. 72) u/L) than those in LH group ((48.30± 5. 06),(40. 50± 11. 38) u/L) after operation (P< 0.05), and lower than those before operation (P<0. 05). The 1-, 2- and 3-year survival rates showed no significant differences between RFA group (85. 71%, 81. 63%, 67. 35%) and LH group (89. 58%, 85. 42%, 68. 75%)(P> 0. 05). Conclusion Ultrasound-guided RFA combined with anhydrous ethanol injection has the same therapeutic result as LH, and it has lower complication incidence and can effectively improve liver function.
作者
崔海峡
王勇
高瑛
任江萍
CUI Haixia;WANG Yong;GAO Ying;REN Jiangping(Department of Ultrasound ,Sanmenxia Central Hospital,Sanmenjcia 472000,China)
出处
《中华实用诊断与治疗杂志》
2019年第7期700-703,共4页
Journal of Chinese Practical Diagnosis and Therapy
关键词
小肝癌
超声引导
射频消融术
无水乙醇
腹腔镜肝切除术
肝功能
small hepatocellular carcinoma
ultrasound guidance
radiofrequency ablation
anhydrous ethanol
laparoscopic hepatectomy
liver function
