摘要
目的比较腹腔镜切除术(LR)、开腹切除术(OR)与超声定位下的射频消融术(RFA)治疗肝细胞癌的近期临床疗效。方法回顾性分析2010年6月至2018年6月接受手术治疗的152例肝细胞癌患者的病例资料,71例患者纳入LR组,52例患者纳入OR组,29例患者纳入RFA组。采用SPSS 25.0软件分析数据,手术相关指标、VAS评分等计量资料以(±s)描述,行f检验;近期疗效、并发症等计数资料行χ^2检验,P<0.05为差异有统计学意义。结果三组患者术后3个月治疗总有效率比较,LR组(76.1%)>OR组(73.1%)>RFA组(72.4%),差异无统计学意义(P>0.05)。三组手术时间、术中总出血量及住院时间相比,OR组>LR组>RFA组(P<0.05);术后24 h及1周后VAS评分比较,OR组>LR组>RFA组(P<0.05);OR组并发症总发生率(36.5%)>LR组(29.6%)>RFA组(6.7%),差异有统计学意义(P<0.05);术后随访3个月的复发率比较,OR组(7.7%)<LR组(8.5%)<RFA组(10.3%)差异无统计学意义(P>0.05)。结论对分期早且肿瘤小的肝细胞癌患者分别采用LR术、OR术与RFA术治疗,患者近期疗效相当,但RFA术具有损伤小、术后恢复快等优点,可减轻患者术后疼痛程度,安全性更高。但对于瘤体较大且靠近重要血管胆管的肝细胞癌患者,还需进行个体化治疗。
Objective To compare the short-term clinical efficacy of laparoscopic resection(LR),open resection(OR)and radiofrequency ablation under ultrasound localization for hepatocellular carcinoma(RFA).Methods The data of 152 patients with hepatocellular carcinoma who underwent surgery in our hospital from June 2010 to June 2018 were retrospectively analyzed.71 patients who were treated with laparoscopic resection(LR)were included in the LR group,52 patients who were treated with open resection(OR)were included in the OR group,and 29 patients who were treated with ultrasound-localized radiofrequency ablation(RFA)were included in the RFA group.SPSS 25.0 software package was used to verify the entire group of data.Measurement data such as surgery-related indicators and VAS scores were described by and t tests were performed.Frequency(n)and rate(%)were used for counting data such as recent efficacy and complications.Description,χ^2 test was performed,and comparison among multiple groups was performed by one-way analysis of variance.P<0.05 was considered statistically significant.Results Comparing the total effective rate of three groups of patients 3 months after operation,LR group(76.1%)>OR group(73.1%)>RFA group(72.4%),but the difference was not statistically significant(P>0.05);The operation time,total bleeding volume and hospitalization time of the three groups were compared,the OR group>Lr Group>RFA group(P<0.05);The Vas scores after 24 hours and 1 week after operation were compared,the overall incidence of complications in the OR group(36.5%)>LR group(29.6%)>RFA group(6.7%)(P<0.05);The comparison of the recurrence rate after 3 months of follow-up,OR group(7.7%)<LR group(8.5%)<RFA group(10.3%)(P>0.05).Conclusion For patients with hepatocellular carcinoma with early stage and small tumors treated with LR,OR,and RFA,the recent treatment results are comparable,but compared with LR and OR,RFA has less damage and faster postoperative recovery Advantages can reduce the degree of postoperative pain and higher safety.However,for patients with hepatocellular carcinoma with large tumors and close to important vascular bile ducts,individualized treatment is still needed.
作者
唐聃
刘公伟
敖宇
谭阳
杨秀智
李雄雄
蔡治方
赵礼金
Tang Dan;liu Gongwei;Ao Yu;Tan Yang;Yang Xiuzhi;Li Xiongxiong;Cai Zhifang;Zhao Lijin(Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital of Zunyi Medical University ,563000;Hepatobiliary and Pancreatic Surgery,Affiliated Hospital of Zunyi Medical University ,563003)
出处
《中华普外科手术学杂志（电子版）》
2020年第6期577-580,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
合肥市科技局合肥医科大学市校联合基金[遵市科合HZ字(2019)8号]
贵州省教育厅创新群体重大研究课题(黔科合KY字[2016]039)。
关键词
癌
肝细胞
腹腔镜
剖腹术
超声定位下的射频消融术
疗效比较研究
Carcinoma,hepatocellular
Laparoscopes
Laparotomy
Radiofrequency ablation under ultrasound localization
Comparative effectiveness research
