射频辅助肝切除术的可行性、安全性和有效性

The feasibility,safety and effectiveness of radiofrequency ablation in liver resection

目的探讨肝癌病人实施肝脏切除手术中采用射频辅助肝切除的临床应用效果。方法回顾性分析武汉大学人民医院2016年1月至2018年9月128例实施开腹肝脏手术切除病灶的病例资料,根据切除方法分为射频组59例、常规组69例(行常规肝脏切除),对比两种手术方法的相关指标、术后并发症。结果射频组的总出血量、切肝出血量、切肝时间、肝门阻断时间均低于常规组,差异有统计学意义(P<0.05);两组间手术时间、术后住院时间比较差异无统计学意义(P>0.05);术前、术后第1、3、7天,两组病人的血清白蛋白(ALB)、总胆红素(TBIL)、丙氨酸转氨酶(ALT)测定值差异无统计学意义(P>0.05);两组病人术后第1、3天血清ALB较术前均降低(P<0.05),两组病人术后第1、3、7天TBIL、ALT测定值较术前均升高(P<0.05);射频组手术并发症发生率(16.95%)低于常规组病人(23.19%),但差异无统计学意义(P>0.05)。结论肝癌病人实施肝脏切除手术中采用射频辅助肝切除具有减少手术出血量及肝门阻断时间的作用,同时并不会增加手术并发症及肝功能损害。

Objective To investigate the clinical effect of radiofrequency assisted hepatectomy in patients with liver cancer undergoing hepatectomy.Methods A total of 128 patients who received laparotomy for resection of liver lesions in our hospital from January 2016 to September 2018 were selected and retrospectively analyzed.They were divided into radiofrequency group(59 cases)and conventional group(69 cases)according to resection methods.Relevant indicators and postoperative complications were compared between the two surgical methods.Results The total blood loss,hepatectomy blood loss,hepatectomy time and hepatic portal occlusion time in radiofrequency group were lower than those in conventional group,and the differences had statistical significance(P<0.05);the differences in the operation time and postoperative hospital stay between the two groups had no statistical significance(P>0.05);the differences in the measured values of serum ALB,TBIL and AST before operation and on postoperative days 1,3 and 7 in radiofrequency conventional group had no statistical significance(P>0.05);the serum ALB before operation on postoperative days 1 and 3 in both groups decreased(P<0.05),and the measured values of TBIL and ALT on postoperative days 1,3 and 7 increased in both groups(P<0.05);the surgical complications in radiofrequency group were 16.95%lower than 23.19%in conventional group,but the differences had no statistical significance(P>0.05).Conclusion Radiofrequency assisted hepatectomy in patients with liver cancer can reduce the intraoperative blood loss and hepatic portal occlusion time,without increasing surgical complications and liver function damage.