超声引导下腹腔镜射频消融术治疗肝血管瘤的疗效及安全性

Efficacy and safety of ultrasound-guided laparoscopic RFA in the treatment of hepatic hemangioma

目的 :探讨经腹腔镜联合超声引导射频消融术治疗肝血管瘤(HCH)的临床应用并评价疗效及安全性。方法:回顾性分析2010年8月—2015年8月收治的81例HCH患者的临床资料。其中腹腔镜下射频消融33例(LRFA组),腹腔镜下切除22例(LR组),开腹手术切除26例(开腹组)。对比各组术前和术后肝功能的变化;记录各组手术时间、住院时间、出血量、术后并发症等并进行比较分析。结果:(1)3组对肝功能指标的影响均为一过性;(2)LRFA组并发症发生率(15.2%)明显低于LR组(36.4%)及开腹组(50.0%),差异有统计学意义(P<0.05);(3)开腹组手术时间、住院时间明显长于其他两组(P<0.05);LRFA组术中无明显出血及输血病例,少于LR组及开腹组。结论 :LRFA治疗HCH,兼具腹腔镜及射频消融的优点,加之联合腔镜超声引导使之更加安全可靠,并发症少,是一种安全、有效的治疗方法,值得临床推广。

Objective:To evaluate the laparoscopic joint comeback guided radiofrequency ablation for hepatic hemangioma clinical application and evaluation of efficacy and safety.Methods:The clinical data were treated from August 2010 to August 2015 period 81 cases of hepatic hemangioma(HCH)patients analyzed.Patients met the inclusion criteria were divided into 33 cases of laparoscopic radiofrequency ablation(LRFA)group,laparoscopic resection(LR)group 22 cases,26 cases of open surgery group.Changes were detected before and after surgery of liver function;record the operation time and hospital stay,blood loss,postoperative complications and compared.Results:Effect of three groups of liver function are transient in nature.LRFA complication rate(15.2%)was significantly lower than the LR group(36.4%)and surgical resection group(50.0%),the difference was statistically significant(P<0.05.Open surgery operative time,hospital stay was significantly longer than the other two groups;and LRFA group of patients had no bleeding,no blood transfusion cases,significantly lower than the LR and open surgical resection group.Conclusion:LRFA treatment HCH,both advantages and laparoscopic radiofrequency ablation,combined with joint endoscopic ultrasonic guidance makes it more secure and less complications,is a safe and effective method of treatment of hepatic hemangioma,worthy of promotion.