特殊部位小肝癌患者经皮和经腹腔镜下微波消融治疗比较

Comparison of clinical effects of percutaneous microwave ablation and laparoscopic microwave ablation in treatment of small hepatocellular carcinoma patients with special site

目的探讨分析特殊部位小肝癌患者经皮微波消融和腹腔镜下微波消融治疗的临床效果。方法选取2013年3月到2017年3月于高州市人民医院进行治疗的60例特殊部位小肝癌患者,随机分为对照组和观察组,每组30例。观察组患者采用腹腔镜下微波消融进行治疗,对照组采用经皮微波消融治疗。观察对比两组患者手术过程中肿瘤病灶消融治愈率、肿瘤再发生、手术指标、肝功能和并发症。结果手术后1周,观察组患者肿瘤病灶消融治愈率显著高于对照组(χ~2=7.39,P=0.01),两组患者肿瘤复发率的差异无统计学意义(χ~2=1.45,P=0.68);两组患者的TBil、ALT和AST水平与术前相比差异无统计学意义(P均>0.05)。观察组患者并发症发生率显著低于对照组(χ~2=6.52,P<0.001)。结论特殊部位小肝癌患者采用腹腔镜下微波消融治疗的临床效果较好,肿瘤病灶消融率较高,并发症发生率低,具有较高的临床应用价值,值得应用推广。

Objective To investigate the clinical effect of percutaneous microwave ablation and laparoscopicmicrowave ablation in treatment of small hepatocellular carcinoma patients with special site. Methods Totalof 60 small hepatocellular carcinoma patients with special site in Gaozhou People’s Hospital from March2013 to March 2017 were selected and randomly divided into observation group and control group, 30 casesin each group. Patients in control group were treated with percutaneous microwave ablation, and patientsin observation group were treated with microwave ablation under laparoscope. The new lesions, tumorfocus, ablation, tumor recurrence, operation parameters, liver function and complications were observed andcompared between the two groups. Results One week after the operation, the cure rate of tumor lesions inobservation group was significantly higher than that in control group （χ2 = 7.39, P = 0.01）, and there was nosignificant difference in tumor recurrence rate between the two groups （χ2 = 1.45, P = 0.68）. There was nosignificant difference in serum TBil, ALT and AST levels between the two groups before and after operation（P 〉 0.05）. The incidence of complications in observation group was significantly lower than that in controlgroup （χ2 = 6.52, P 〈 0.001）. Conclusions The clinical effect of laparoscopic microwave ablation for smallhepatocellular carcinoma patients with special site is better, the ablation rate of tumor focus is higher, and theincidence of complications is lower, which had a high clinical application value and is worth popularizing.