经皮射频消融术与手术切除治疗小肝癌患者的近远期疗效及安全性比较

Long term efficacy and safety of PRFA and surgical resection in patients with small hepatocellular carcinoma compared

[目的]比较经皮射频消融术(PRFA)和手术切除治疗小肝癌的临床效果和对肝脏保护作用。[方法]研究对象选取我院2012年4月~2013年6月间收治的小肝癌患者108例,采用随机数字法将其分为手术组和射频组,每组各54例。手术组患者行手术切除治疗,射频组患者行PRFA治疗。比较2组患者的住院时间、术后3年内复发率、并发症发生率及术后1年、2年及3年的生存率,同时比较术前和术后5d的肝功能指标变化。[结果]射频组的住院时间明显低于手术组(t=6.71,P=0.00),射频组的总并发症发生率(9.25%)明显低于手术组(24.07%)(χ~2=4.27,P=0.03)。术后5d,射频组的ALT水平明显低于手术组(P<0.01)。2组术后3年内的复发率比较差异无统计学意义,2组患者术后1年、2年及3年的生存率比较差异均无统计学意义。[结论]PRFA治疗小肝癌的效果显著,术后并发症及复发率低,对肝脏损害较轻,有效提高生存期,且术后并发症较低,治疗安全性较高,值得在临床推广。

[Objective]To compare the clinical effects and the protective effects on liver of percutaneous radiofrequency ablation（PRFA）and surgical resection on small hepatocellular carcinoma [Methods]The subjects were 108 patients with small hepatocellular carcinomat in our hospital from April 2012 to June 2013,who were randomly divided into operation group and radio frequency group,54 patients in each group.The operation group were treated by surgical resection,while the radio frequency group were treated with PRFA.The hospital time,the recurrence rate and the incidence of complications within 3 years after surgery,and the survival rate of 1 year,2 years and 3 years after surgery were compared between the two groups of patients.The changes of liver function indexes before and after 5 days surgery were compared.[Results]The hospitalization time of the radio frequency group was significantly lower than the operation group（t=6.71,P=0.00）.The total incidence of complications in the radio frequency group（9.25%）was significantly lower than the operation group（24.07%）（χ~2=4.27,P=0.03）.Five days after surgery,the ALT levels of the radio frequency group was significantly lower than the operation group（P0.01）.The recurrence rate after 3 years between the two groups were not significant different.There was no significant difference in survival rates between the two groups after 1 year,2 years and 3 years surgery.[Conclusion]PRFA has significant effect in the treatment of small hepatocellular carcinoma,with lower postopera-tive complications and recurrence rate,less damage to the liver,and better improvement in the survival,and higher safety of treatment.It is worth in clinical promotion.