腹腔镜下射频消融术与腹腔镜下肝切除术治疗肝细胞癌合并门静脉高压患者的疗效观察

Efficacy of laparoscopic radiofrequency ablation and hepatectomy in patients with hepatocellular carcinoma complicated with portal hypertension

目的探讨腹腔镜下射频消融术与腹腔镜下肝切除术治疗肝细胞癌合并门静脉高压患者的治疗效果。方法选取2017年1月至2018年5月间渭南四号骨伤医院和宝鸡市第二人民医院收治的104例肝细胞癌合并门静脉高压患者,根据治疗方案不同进行分组,将行腹腔镜下射频消融治疗的52例患者作为观察组,行腹腔镜下肝切除术治疗的52例患者作为对照组。比较两组患者的疾病临床控制情况、疼痛程度、术后近期生存情况及并发症发生情况。结果观察组患者的临床总控制率为98. 1%,高于对照组患者的82. 7%,差异有统计学意义(P <0. 05)。观察组患者术后即刻及术后1周的VAS评分均低于对照组患者,差异均有统计学意义(均P <0. 05)。观察组患者的并发症总发生率为3. 8%,低于对照组患者的13. 5%,差异有统计学意义(P <0. 05)。结论腹腔镜下射频消融术治疗肝细胞癌合并门静脉高压患者,可有效控制患者病情,降低疼痛程度,安全性较高,并发症发生率较低,临床推广应用价值较高。

Objective To analyze the efficacy of laparoscopic radiofrequency ablation and liver resection in patients with hepatocellular carcinoma complicated with portal hypertension.Methods A total of104 patients with hepatocellular carcinoma complicated with portal hypertension who were admitted to Weinan Orthopedic Hospital and Baoji Second People’s Hospital from January 2017 to May 2018 were enrolled in the study.Patients were divided into an observation group and a control group with 52 patients in each group.Patients undergoing radiofrequency ablation were included in the observation group and patients undergoing radiofrequency hepatectomy were included in the control group.The clinical control of the disease,the degree of pain,the recent survival after surgery and the occurrence of complications were compared between the two groups.Results The overall clinical control rate was 98.1%in the observation group which was significantly higher than in the control group(P<0.05).The visual analog scale(VAS)was lower in the observation group than in the control group immediately after the surgery and at 1 week after surgery(all P<0.05).The incidence of postoperative complications was 3.8%in the observation group,which was lower than 13.5%of the control group(all P<0.05).Conclusion The clinical application of radiofrequency ablation can effectively control the patient’s condition in patients with hepatocellular carcinoma complicated with portal hypertension with low pain,high safety and low complication rate.The clinical promotion and application value is high.