射频消融术辅助部分肝切除术治疗原发性肝癌的效果及复发率随访研究

摘要

目的 探讨射频消融术辅助部分肝切除术治疗原发性肝癌的效果及复发率随访研究.方法 以2013年3月～ 2015年10月我院肝胆外科收治的60例原发性肝癌为研究对象,随机数字表法将其均分为对照组及研究组各30例,对照组实施部分肝切除术治疗,研究组在对照组基础上另联合射频消融术辅助治疗,观察2组手术相关指标[手术时间、创面平均出血量、术后住院时间]、术前术后肝功能指标[谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)]、并发症发生率及随访复发率.结果 研究组手术时间、术后住院时间较对照组显著短,而创面平均出血量较对照组显著低,差异有统计学意义(P＜0.05);术前2组ALT、TBiL、AST相较无明显差异(P＞0.05);术后2组ALT、TBiL、AST较术前明显降低,且术后研究组各项指标的变化程度较对照组明显(P＜0.05);术后研究组并发症发生率、术后1年随访复发率较对照组显著低,差异有统计学意义(P＜0.05).结论 射频消融术在原发性肝癌患者部分肝切除术中有明显积极作用,符合现代无血肝切除的理念,具有术中出血量少、康复时间短、保护肝功能、术后并发症及复发率低的优势,有推广应用价值.%Objective To investigate the effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer.Methods A total of 60 patients with primary liver cancer treated in our hospital from March 2013 to October 2015were selected as study subjects and were divided into the control group and the study group by the random number table method,30 cases in each group.The control group were treated with partial hepatectomy.On the basis,the study group were treated with radiofrequency ablation.The operation associated indexes(operation time,the average wound bleeding volume,postoperative length of hospital stay),preoperative and postoperative liver function indexes [alanine aminotransferase (ALT),total bilirubin (TBIL),aspartate aminotransferase (AST)],the incidence of complications and recurrence rates in the two groups were observed.Results The operation time and postoperative length of hospital stay of the study group were significantly shorter than those of the control group,and the average bleeding volume was significantly less than that of the control group (P ＜ 0.05).There was no significant difference in ALT,TBiL and AST between the two groups before operation (P ＞ 0.05).After operation,ALT,TBiL and AST in the two groups were significantly lower than those before operation,and the changes in the study group were greater than those in the control group (P ＜ 0.05).The incidence of postoperative complications and the recurrence rate in 1 year after operation were significantly lower than those in the control group (P ＜ 0.05).Conclusion Radiofrequency ablation has obvious positive effect in patients with primary liver cancer undergoing partial hepatectomy.It has advantages of little bleeding,short rehabilitation time,protecting liver function,few postoperative complications and low recurrence rate.