经皮穿刺微波消融术与腹腔镜切除肝癌预后的比较研究

Prognosis Research of Laparoscopic Surgery and Percutaneous Microwave Ablation in Treating Hepatic Carcinoma

目的:探讨在肝癌治疗中分别应用腹腔镜切除术与经皮穿刺微波消融术对患者预后影响。方法:从我院2010年3月至2012年3月收治的肝癌患者中选取90例为研究对象,经随机数字表法分为A组45例,B组45例,A组行经皮穿刺微波消融术治疗,B组行腹腔镜切除术治疗,观察两组患者手术时间、术中出血量及预后效果。结果:A组患者手术时间及术中出血量情况明显优于B组(P<0.05);A组并发症发生为6.67%,同B组比较,明显较低(P<0.05);A组局部复发率为20.00%,同B组8.89%比较,明显较高(P<0.05),总复发率无明显差异(P>0.05);两组患者术后1、2、3年存活率均无明显差异(P>0.05)。结论:在肝癌治疗中,经皮穿刺微波消融术与腹腔镜切除远期疗效均较好,经皮穿刺微波消融术创伤小,并发症发生率低,对预后改善具有重要作用。

Objective： To investigate the curative effects and prognosis of laparoscopic surgery and percutaneous microwave ablation in treating hepatic carcinoma. Methods： 90 hepatic carcinoma patients from March 2010 to March 2012 were selected and randomly divided them into Group A and Group B, each with 45 cases. Group A was given percutaneous microwave ablation and Group B was given laparoscopic surgery. The surgical curative effects and prognosis was observed. Results： The operation time in group A was shorter than that of group B, and the intraoperative blood loss was obviously less than that of group B（P〈0.05）. The occurrence rate of complications was 6.67 % in group A, which was obviously lower than the group B（P〈0.05）; the local recurrence rate was 20.00 % which was obviously higher than 8.89 % of the group B（P〈0.05）, but the total recurrence rate had no obvious significance（P〈0.05）. The survival rate of 1 year, 2 years and 3 years after the surgery had no obvious significance between two groups（P〈0.05）. Conclusions： Laparoscopic surgery and percutaneous microwave ablation both have good long-term effect in treating hepatic carcinoma, but the percutaneous microwave ablation has less trauma and lower complication rate, which can obviously improve the prognosis.