原发性小肝癌氩氦刀与无水酒精注射治疗对比研究

Comparative study on treatment of small hepatocellular carcinoma by argon super cryosurgery system and percutaneous ethanol injection

目的探讨氩氦刀和经皮穿刺无水酒精注射治疗治疗原发性小细胞肝癌患者的最佳适应证。方法对67例小细胞肝癌进行了氩氦刀和经皮穿刺无水酒精注射,其中氩氦刀组21例共37个病灶,经皮穿刺无水酒精注射组46例共59个病灶。比较患者氩氦刀及经皮穿刺无水酒精注射1、2、3年生存率和并发症,统计两组患者的医疗费用。结果两组患者术后均无严重并发症;氩氦刀组术后1、2、3年生存率分别为91.3%、76.4%和62.8%;经皮穿刺无水酒精注射组病患者术后1、2、3年生存率分别为78.0%、60.0%、47.8%;氩氦刀组患者平均治疗费用明显高于经皮穿刺无水酒精注射组。结论对于小细胞肝癌,氩氦刀疗效优于经皮穿刺无水酒精注射;对于位于肝包膜下的小细胞肝癌,以经皮穿刺无水酒精注射为宜;经皮穿刺无水酒精注射费用低廉,患者依从性较好。

Objective To investigate the best adaptation of argon super cryosurgery system （ASCS） and percutaneous ethanol injection （PEI） in the treatment of small hepatocellular carcinoma （SHCC）. Methods Sixty - seven patients with 96 lesions were treated by ASCS or PEI. Twenty- one patients with 37 nodules were in ASCS group,and fourty -six patients with 59 nodules were in PEI treatment （PEIT） group. The complications, cost for treatments, and survival rate of 1,2,3 -year were compared. Results No severe complications were observed in all patients. Survival rate of 1,2,3 - year was 91.3% ,76.4% ,62.8 % in ASCS group and 75.7% ,60.0% ,47.8% in PEIT group, respectively. The cost of treatment was lower in PEIT group than in ASCS group. Conclusions Therapeutic effect of ASCS on SHCC is better, but the cost of PEIT is cheaper. For liver subcapsular tumors or lesions near the vessel, PEIT may be the better choice for treatment.