摘要
目的:探讨超声引导下经皮肝射频消融与腹腔镜肝切除术治疗直径2～5 cm肝细胞癌(HCC)的临床疗效.方法:回顾性收集2016年1月至2020年12月43例行超声引导下经皮射频消融治疗的患者(射频组)及54例腹腔镜下肝切除术治疗的HCC患者(手术组)的临床资料,比较两组患者术后指标、并发症及1年、3年、5年生存情况以及复发情况.结果:射频组与手术组比较,术后指标血清丙氨酸氨基转移酶(ALT)与天冬氨酸氨基转移酶(AST)以及总胆红素(TBIL)水平更低,术后并发症发生率更低,术后住院时间及总住院时间更短(P<0.05).两组患者术后 1年、3年、5年生存率及复发率差异均无统计学意义(P>0.05).多因素分析显示Child-Pugh分级(P<0.001)为影响HCC患者总生存率的独立危险因素.结论:对于直径2～5 cm肝癌,消融联合其他治疗方案能取得与腹腔镜肝切除术切除相当的治疗效果,并且具有手术时间短、创伤小、术后并发症少、住院时间短、恢复快的优点.
Abstract
Objective:To explore the clinical efficacy of percutaneous radiofrequency ablation(RFA)and laparoscopic hepatectomy in the treatment of hepatocellular carcinoma(HCC)with a diameter of 2-5 cm.Methods:The clinical data of 43 patients with HCC treated by percutaneous RFA under the guid-ance of ultrasound(RFA group)and 54 patients with HCC treated by laparoscopic surgical resection(SR group)from January 2016 to December 2020 were analyzed retrospectively.The postoperative in-dexes,complications,1-year,3-year,and 5-year survival rates,and recurrence of the two groups were compared.Results:Compared with those in the SR group,the levels of serum alanine amino-transferase(ALT),aspartate transaminase(AST),and total bilirubin(TBIL)in the RFA group were lower,the incidence of postoperative complications was significantly lower,and the postopera-tive hospital stay and total hospital stay were shorter(P<0.05).There was no significant difference in the 1-year,3-year,and 5-year survival rates and recurrence rates between the two groups(P>0.05).Multivariate analysis showed that Child-Pugh classification(P<0.001)was an independent risk factor affecting the overall survival of patients with HCC.Conclusion:For HCC with a diameter of 2-5 cm,radiofrequency ablation combined with other treatment options can achieve a similar therapeutic effica-cy as laparoscopic hepatectomy.Radiofrequency ablation had the advantages of short operation time,less trauma,fewer postoperative complications,short hospital stay,and rapid recovery.
基金项目
武汉大学中南医院科技创新培育基金(znpy2019081)
NETL
NSTL
万方数据