肝切除术中联合微波热凝治疗原发性肝癌疗效分析（附118例报道）

Efficacy of hepatectomy combined with microwave coagulation therapy for primary liver neoplasms： report of 118 patients

目的探讨肝切除术中联合微波热凝治疗原发性肝癌的疗效。方法回顾性分析118例原发性肝癌患者的临床资料，118例分为A、B两组，A组行单纯肝叶切除术，B组行肝切除术中联合微波热凝处理肝创面，对比术后肝功能、近期并发症、复发率以及生存率等指标。结果所有患者皆顺利完成手术；B组术后第1、4天的丙氨酸转氨酶均高于A组的（t=10．614，P=0．000和t=9．993，P=0．000）；两组术后总胆红素和白蛋白（均P〉0．05）以及近期并发症（X^2=0．008，P：0．930）差异均无统计学意义；A组的1年复发率高于B组（36．36％比15．87％，X^2=6．503，P=0．011），1年生存率低于B组（76．36％比90．48％，X^2=4．239，P：0．037），差异均有统计学意义。结论肝切除术中联合微波热凝治疗原发性肝癌具有良好的安全性，并且能显著降低1年复发率和提高1年生存率，为原发性肝癌的治疗提供新的方法。

Objective To explore the efficacy of hepatectomy combined with microwave coagula- tion therapy for primary liver neoplasms. Methods A total of 118 cases of primary liver neoplasm were divided into two groups：group A was treated with hepatectomy, and group B was treated with hepatectomy combined with microwave coagulation therapy. The clinical data were analyzed retrospectively to compare postoperative liver function, early - stage complications, recurrence rate and survival rate between two groups. Results All patients underwent operation successfully. Postoperative alanine aminotransferase in group B was significantly higher than in group A at 1 day and 4 days after treatment（t = 10. 614,P = 0. 000 and t = 9. 993 ,P = O. 000, respectively）. Postoperative total bilirubin, albumin（ P 〉 0.05 ） and early -stage complications（ X^2 = 0. 008, P = 0. 930）were not significantly different between group A and group B. The 1 - year recurrence rate in group A was significantly higher than in group B（36.36% vs. 15.87% , X^2 = 6. 503 ,P = 0. 011 ）and the 1 -year survival rate in group A was significantly lower than in group B （ 76.36% vs. 90.48% , X^2 = 4. 239, P = 0. 037 ）. Conclusion Hepatectomy combined with microwave coagulation therapy can effectively decrease the 1 - year recurrence rate and improve the 1 - year survival rate with good safety, and it can be taken into account as a new procedure to treat primary liver neoplasms.