射频消融与腹腔镜手术治疗肝癌的临床效果比较

Comparison of Efficacy of Radiofrequency Ablation and Laparoscopic Surgery in Treatment of Liver Cancer

目的:比较射频消融与腹腔镜手术治疗肝癌的效果.方法:选取笔者所在医院收治的98例肝癌患者作为研究对象,依据随机数字表法分成消融组和腔镜组,各49例.消融组给予经皮射频消融(RFA)治疗,腔镜组给予腹腔镜肝切除术治疗.比较两组术前及术后1个月肝功能指标[丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)]水平差异,比较两组术后2个月时肿瘤根治率及术后6、12个月时肿瘤复发率,观察两组术后1个月内并发症发生情况.结果:术后1个月,两组ALT和AST水平均低于术前,且消融组均低于腔镜组,差异均有统计学意义(P<0.05).术后2个月时,两组肿瘤根治率比较差异无统计学意义(P>0.05);术后6、12个月时,两组肿瘤复发率比较差异无统计学意义(P>0.05).术后1个月内,消融组术后并发症总发生率低于腔镜组,差异有统计学意义(P<0.05).结论:RFA与腹腔镜肝癌切除术治疗原发性小肝癌效果相当,但RFA治疗术后并发症发生风险低,安全性良好且术后肝功能恢复较快,对患者预后康复更有利.

Objective:To compare the efficacy of radiofrequency ablation and laparoscopic surgery on liver cancer.Method:A total of 98 patients with liver cancer admitted to our hospital were selected as the research subjects.According to the random number table method,the patients were divided into the ablation group and the laparoscopic group,with 49 cases in each group.The ablation group was treated with percutaneous radiofrequency ablation(RFA)while the laparoscopic group was treated with laparoscopic hepatectomy.The differences of liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]were compared between the two groups before surgery and at 1 month after surgery.The rate of tumor radical surgery at 2 months after surgery and tumor recurrence rate at 6 and 12 months after surgery were compared between the two groups.The occurrence of complications within 1 month after surgery were observed in the two groups.Result:At 1 month after surgery,the levels of ALT and AST in the two groups were significantly lower than those before surgery,and the levels in the ablation group were significantly lower than those in the laparoscopic group,the differences were statistically significant(P<0.05).At 2 months after surgery,there was no significant difference in the rate of tumor radical surgery between the two groups(P>0.05).There was no significant difference in tumor recurrence rate between the two groups at 6 and 12 months after surgery(P>0.05).Within 1 month after surgery,the total incidence rate of postoperative complications in the ablation group was significantly lower than that in the laparoscopic group,the difference was statistically significant(P<0.05).Conclusion:RFA and laparoscopichepatectomy are equivalent in the treatment of patients with primary small hepatocellular carcinoma,but RFA has lower risk of postoperative complications,better safety and faster postoperative liver function recovery,and it is more advantageous to prognosis and rehabilitation of patients.