多针双电极适形射频消融技术治疗肝脏巨大血管瘤的效果及安全性

Curative effects and safety of comformal radiofrequency ablation with a multi-pin bipolar system for massive hepatic hemangiomas

目的:探究多针双电极适形射频消融技术治疗肝脏巨大血管瘤的效果以及安全性。方法:回顾性分析2014年8月至2019年8月郑州市第六人民医院收治的60例肝脏巨大血管瘤患者的临床资料,依据患者手术方式将接受多针双电极适形、腹腔镜以及开腹射频消融技术患者分别纳入适形组(n=23)、腹腔镜组(n=19)以及开腹组(n=18)。比较三组患者的治疗效果、围术期相关指标及术后并发症发生情况。结果:三组患者技术成功率比较差异未见统计学意义(P>0.05)。适形组患者完全消融比例(23/23)高于腹腔镜组(14/19)及开腹组(11/18),P<0.05;腹腔镜组与开腹组患者完全消融率比较差异未见统计学意义(P>0.05)。适形组患者手术时间、出血量、住院时间以及住院支出少于腹腔镜组和开腹组,腹腔镜组患者手术时间、出血量、住院时间以及住院支出少于于开腹组,组间比较差异有统计学意义(P<0.05)。适形组、腹腔镜组以及开腹组患者并发症发生比例分别为1/23、6/19、10/18,适形组患者并发症发生比例低于腹腔镜组和开腹组(P<0.05)。结论:多针双极适形射频消融技术治疗肝脏巨大血管瘤的效果较好,并发症较少,安全性较高,临床应用价值较高。

Objective To investigate the curative effects and safety of comformal radiofrequency ablation(RFA)for massive hepatic hemangiomas(MHH)with a multi-pin bipdar system.Methods A retrospective analysis was performed on clinical data of 60 MHH patients who were admitted to the Sixth People’s Hospital of Zhengzhou from August 2014 to August 2019.According to surgery procedures,patients who underwent comformal RFA with a multi-pin bipdar system,laparoscopic RFA and open RFA were included into comformal group(n=23),laparoscopic group(n=19)and open group(n=18)respectively.The curative effect,perioperative related indexes and postoperative complications were compared among the three groups.Results There was no significant difference in technical success rate among the three groups(P>0.05).The complete ablation rate in conformal group was 23/23,significantly higher than the 14/19 in laparoscopic group and 11/18 in open group(P<0.05).There was no significant difference in complete ablation rate between laparoscopic group and open group(P>0.05).The operation time,blood loss,hospital stay and hospitalization expenditure in conformal group were lower than those in laparoscopic group and open group,and the above indexes in laparoscopic group were lower than those in open group(P<0.05).The incidence of complications in conformal group,laparoscopic group and open group were 1/23,6/19,10/18,respectively.The incidence of complications in conformal group was significantly lower than that in laparoscopic group and open group(P<0.05).Conclusions The curative effect of comformal RFA with a multi-pin bipolar system is good on MHH,with less complications,higher safety and higher clinical application value.