不同肝泡型包虫病患者射频消融术后肝功能比较

Comparison of changes in liver function in patients with different types of hepatic alveolar echinococcosis after radiofrequency ablation

目的比较不同类型肝泡型包虫病患者射频消融术后肝功能变化。方法回顾分析2016年12月至2018年12月青海省人民医院行射频消融治疗的32例肝泡型包虫病患者资料,男性12例,女性20例。入选患者按包虫病灶数目分为单发组(n=17)和多发组(n=15),按病灶直径分为微小组(n=12)和大中组(n=20)。比较各组患者的手术时间和术后AST、ALT变化。结果单发组手术时间为1.5(1.0,1.8)h,多发组为3.0(1.5,3.5)h,差异有统计学意义(P<0.05)。术后第1天、第3天,多发组ALT高于单发组,差异有统计学意义(P<0.05)。与本组术后第1天比较,两组术后第5天ALT均下降,差异有统计学意义(P<0.05)。单发组和多发组AST比较结果与ALT基本一致。微小组手术时间为1.0(1.0,1.9)h,大中组为2.5(1.5,3.0)h,差异有统计学意义(P<0.05)。术后第1天、第3天、第5天,微小组ALT低于大中组,差异有统计学意义(P<0.05)。与本组术后第1天比较,两组术后第5天ALT均降低,差异有统计学意义(P<0.05)。微小组仅术后第1天AST低于大中组,差异有统计学意义(P<0.05)。结论单发病灶、病灶直径小的肝泡型包虫病患者射频消融治疗手术时间更短,术后肝功能损害更小。

Objective To compare the changes in liver function in patients with different types of hepatic alveolar echinococcosis after radiofrequency ablation.Methods The data of 32 patients with hepatic alveolar echinococcosis treated by radiofrequency ablation from December 2016 to December 2018 at the Qinghai Provincial People's Hospital were retrospectively analyzed.There were 12 males and 20 females.The patients were divided into the single lesion group(n=17)and the multiple lesions group(n=15)according to the number of hydatid lesions.The lesions were further divided into the small lesion group(n=12)and the large or medium lesion group(n=20).The operation time,changes in AST and ALT were compared among these groups.Results The operation time of the single lesion group was 1.5(1.0,1.8)hour,and that of the multiple lesions group was 3.0(1.5,3.5)hour.The difference was statistically significant(P<0.05).On the 1st and 3rd day after treatment,ALT in the multiple lesions group was significantly higher than that in the single lesion group(P<0.05).Compared with the 1st day after operation,ALT of the two groups decreased on the 5th day after treatment,and the difference was statistically significant(P<0.05).The changes in AST in the two groups were basically the same as that of ALT.The operation time of the small lesion group was 1.0(1.0,1.9)hour,and of the large and medium lesion group was 2.5(1.5,3.0)hour.The difference was statistically significant(P<0.05).On the 1st,3rd and 5th day after treatment,ALT in the small lesion group was significantly lower than the large or medium lesion group(P<0.05).Compared with the 1st day after treatment,ALT of the two groups decreased on the 5th day after treatment,and the difference was statistically significant(P<0.05).There was a significant difference in AST between the small lesion group and the large or medium lesion group only on the 1st day after operation(P<0.05).Conclusion Radiofrequency ablation for hepatic alveolar echinococcosis with a single lesion and a small lesion had shorter operation time with less changes in liver function after treatment.