经皮射频消融术与腹腔镜肝癌切除术治疗小肝癌的效果对比

Comparison of effects of percutaneous radiofrequency ablation and laparoscopic liver cancer resection on small hepatocellular carcinoma

目的比较经皮射频消融术与腹腔镜肝癌切除术治疗小肝癌的效果。方法随机抽取2016年1月至2018年12月于解放军联勤保障部队第988医院治疗的小肝癌患者60例,采取随机数字表法将其分为两组,消融组30例行经皮射频消融术,腔镜组30例行腹腔镜肝癌切除术。比较两组患者肝功能指标、肿瘤标志物、并发症及术后生存情况。结果消融组患者术后1个月丙氨酸氨基转移酶为(37.94±5.46)U/L、天门冬氨酸氨基转移酶为(40.73±5.55)U/L,高于腔镜组[(32.32±4.48)U/L、(35.24±5.48)U/L,P<0.05];消融组术后并发症占比为6.67%,低于腔镜组的26.67%(χ2=4.32,P<0.05)。随访5~43个月,消融组生存时间为(32.28±2.98)个月,无瘤生存时间为(27.85±3.03)个月;腔镜组分别为(29.95±3.95)个月、(25.88±3.40)个月,两组比较差异未见统计学意义(t=2.579、2.369,P>0.05)。结论两种方案治疗小肝癌均能延长患者生存时间,射频消融术术后并发症更少,但短期内可能引起一定的肝功能损害。

Objective To compare the effects of percutaneous radiofrequency ablation and laparoscopic hepatectomy on small hepatocellular carcinoma.Methods A total of 60 patients with small hepatocellular carcinoma treated in the 988 Hospital of the Joint service of the People’s Liberation Army from January 2016 to December 2018 were randomly selected and divided into two groups by random number table method. Thirty cases in ablation group were treated by percutaneous radiofrequency ablation, and 30 cases in endoscopic group were treated by laparoscopic hepatectomy. Percutaneous radiofrequency ablation was performed in the ablation group, and laparoscopic liver cancer resection was performed in the endoscopic group. The liver function indexes, tumor markers, complications and postoperative survival of the two groups were compared.Results The alanine aminotransferase was (37.94±5.46)U/L, and the aspartate aminotransferase was (40.73 ± 5.55)U/L in the ablation group at 1 month after operation, which were higher than (32.32±4.48)U/L, (35.24±5.48)U/L in the endoscopic group (P<0.05);the ratio of postoperative complications was 6.67% in the ablation group, which was lower than 26.67% in the endoscopic group (χ2=4.32, P<0.05). The follow-up period ranged from 5 to 43 months. The survival time in the ablation group was (32.28±2.98) months, and the tumor-free survival time was (27.85±3.03) months, which in the endoscopic group were (29.95±3.95) months and (25.88±3.40) months, respectively, but the difference between the two groups was not statistically significant (t=2.579, 2.369, P>0.05).Conclusions Both regimens can be used in the treatment of small hepatocellular carcinoma, by which the survival time of the patients can be prolonged. Radiofrequency ablation has less postoperative complications, but would impair a certain function of liver in the short term.