超声引导下经皮射频消融术与腹腔镜肝切除术治疗小肝癌患者的效果及对肝功能、生存质量的影响

Effects of ultrasound-guided percutaneous radiofrequency ablation and laparoscopic hepatectomy in the treatment of patients with small liver cancer and influences on liver function and quality of life

目的探究超声引导下经皮射频消融术与腹腔镜肝切除术治疗小肝癌患者的效果及对肝功能、生存质量的影响。方法选取2017年2月至2021年1月我院收治的90例小肝癌患者作为研究对象,根据随机数字表法将其分为切除组与消融组,各45例。切除组给予腹腔镜肝切除术,消融组给予超声引导下经皮射频消融术。比较两组的治疗效果。结果治疗后3 d,两组的谷丙转氨酶(ALT)、谷草转氨酶(AST)水平高于治疗前,但消融组低于切除组(P<0.05)。消融组的手术时间、住院时间短于切除组,术中出血量少于切除组,治疗总费用低于切除组(P<0.05)。治疗后1个月,两组的物质功能、社会功能、躯体功能、心理功能评分均高于治疗前,且消融组高于切除组(P<0.05)。治疗后3 d,两组的癌胚抗原(CEA)、甲胎蛋白(AFP)水平均低于治疗前(P<0.05)。消融组的术后并发症总发生率显著低于切除组(P<0.05)。两组的治疗总有效率比较,差异无统计学意义(P>0.05)。两组的复发率、死亡率比较,差异无统计学意义(P>0.05)。结论超声引导下经皮射频消融术与腹腔镜肝切除术治疗小肝癌的效果相似,但前者可更好地减轻手术创伤及患者医疗负担,对肝功的影响更小,可提高患者生存质量。

Objective To investigate the effects of ultrasound-guided percutaneous radiofrequency ablation and laparoscopic hepatectomy in the treatment of patients with small liver cancer and influences on liver function and quality of life.Methods A total of 90 patients with small liver cancer admitted in our hospital from February 2017 to January 2021 were selected as the research objects and divided into resection group and ablation group according to random number table method,with 45 cases in each group.The resection group received laparoscopic hepatectomy,and the ablation group received ultrasound-guided percutaneous radiofrequency ablation.The therapeutic effects of the two groups were compared.Results At 3 d after treatment,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels in the two groups were higher than those before treatment,but those in the ablation group were lower than the resection group(P<0.05).The operation time and hospital stay in the ablation group were shorter than those in the resection group,the intraoperative blood loss was less than that in the resection group,and the total treatment cost was lower than that in the resection group(P<0.05).One month after treatment,the scores of material function,social function,physical function and psychological function in the two groups were higher than those before treatment,and those in the ablation group were higher than the resection group(P<0.05).At 3 d after treatment,carcinoembryonic antigen(CEA)and alpha fetoprotein(AFP)levels in both groups were lower than those before treatment(P<0.05).The total incidence of postoperative complications in the ablation group was significantly lower than that in the resection group(P<0.05).There was no significant difference in the total effective rate of treatment between the two groups(P>0.05).There were no significant differences in the recurrence rate and mortality between the two groups(P>0.05).Conclusion The ultrasound-guided percutaneous radiofrequency ablation and laparoscopic hepatectomy in the treatment of small liver cancer has similar effects,but the former can better reduce the surgical trauma and the medical burden of patients,has less influence on liver function,and improve the quality of life of patients.