射频消融、氩氦刀冷冻对原发性肝癌治疗效果的对比分析

摘要

Objective To explore and compare the treatment effect of primary hepatic carcinoma by applying Ar‐He Cry‐ablation (AHC) and radiofrequency radiation (RF) ,ao as to provide basis for clinical premium treatment technology selec‐tion .Methods In this clinical study ,75 primary hepatic carcinoma (PHC) cases were selected during 2009 and 2010 in accordance with the preset selection criteria and then distributed into AHC group and RF group according to patients’ con‐sent and their physical and disease stages .3‐year follow‐up was implemented after the treatment .Results The general condition of patients between AHC group and RF group was comparable , tumor complete ablation rate in AHC was 97.37% ,and 91 .89% in RF group .Post‐treatment fever incidence was 2 .63% and hepatalgia incidence was 26 .32% in AHC group ,while .Those were 16 .22% and 59 .46% respectively in RF group .The tumor reoccurrence rate was rela‐tively lower in AHC group than in RF group during the 3 years of follow up .The median survival time of patients in AHC group was 36 months ,and the median survival time in RF group was 30 months ,Log‐rank test indicated that the survival period between AHC and RF was statistically meaningful (χ² = 5 .19 ,P < 0 .05) .Conclusion AHC and RF are two treat‐ment methods that both have respective advantage ,which achieve ideal therapeutic effect .But AHC has relatively advanta‐ges in aspects of treatment time ,post‐operative complication rates ,tumor reoccurrence rate ,and survival time and so on . AHC is a tumor minimally invasive treatment technology which is relatively safer ,more reliable and small trauma ,and worth promoting .%目的：分析比较螺旋 CT 引导下射频消融和氩氦刀冷冻治疗对原发性肝癌的治疗效果，为肝癌的临床治疗优选提供依据。方法采用临床试验研究法，根据入选标准，选择2009年9月～2010年12月接受氩氦刀冷冻和射频消融治疗肝癌患者75例，分为两组（AHC 组38人，RF 组37人），治疗后对患者进行3年定期随访。结果两组患者的一般情况可比性好，AHC 组肿瘤完全消融率为97．37％；RF 组完全消融率为91．89％；AHC 组患者发热发生率为2．63％，肝区疼痛发生率为26．32％；明显低于 RF 组患者（16．22％，59．46％）；AHC 组患者3年随访期间肿瘤复发率低于 RF 组患者；AHC 组患者中位生存期为36月，RF 组患者中位生存期为30月，Log‐rank 检验显示两组肝癌患者生存期之间的差异有统计学意义（χ²＝5．19，P ＜0．05）。结论氩氦刀冷冻和射频消融两种治疗方法各具优势，在肿瘤治疗方面均取得良好治疗效果。但氩氦刀冷冻治疗在治疗时间、术后并发症发生率、肿瘤复发率、患者生存率等方面都具有一定的优势，是一种相对更加安全、可靠、创伤小的肿瘤微创治疗技术，值得推广。