射频消融辅助肝切除治疗原发性肝癌的临床应用

Clinical application of radiofrequency ablation assisted hepatectomy to primary hepatocellural carcinoma

摘要:

目的 探讨射频消融辅助开腹肝切除治疗原发性肝癌的安全性和临床疗效。方法 收集2013 年 6 月-2015 年12 月南昌大学第一附属医院接受肝癌切除术的52 例肝癌患者的临床资料进行回顾性分析。观 察组采用射频消融联合肝切除术治疗，对照组采用传统开腹肝切除术治疗，每组患者26 例。比较两组患者手 术时间、术中入肝血流阻断情况、术中出血量、肝癌完全切除率、术后并发症发生率、术后3、6 及12 个月 肿瘤复发情况。结果 两组患者均顺利完成R0 切除。两组患者手术时间比较差异无统计学意义（P >0.05）。 观察组术中出血量、术中入肝血流阻断例数及术后并发症与对照组相比，差异有统计学意义（P <0.05），观察 组均低于对照组。术后3、6 及12 个月两组患者均未见复发转移。结论 相比传统的肝癌切除术，射频消融 联合治疗在不影响治疗效果的同时可有效减少术中入肝血流的阻断次数，降低术中出血量和术后并发症的发 生率，是一种安全有效的治疗方案。

Abstract:

Objective To explore the safety and clinical efficacy of radiofrequency ablation assisted hepatectomy in the treatment of primary hepatocellural carcinoma. Methods The clinical data of 52 hepatocellular carcinoma patients who accepted surgical resection in our hospital from June 2013 to December 2015 were retrospectively analyzed. Among them 26 patients in the observation group underwent radiofrequency ablation and surgical resection, while 26 patients in the control group underwent only surgical procedures. The operation time, situation of occlusion of hepatic blood inflow, intraoperative bleeding, complete resection rate of tumor, postoperative complications and the postoperative cancer recurrence rate in 3, 6 and 12 months after operation were compared. Results The two groups of patients underwent R0 resection successfully. There was no significant difference in the operation time between the two groups (P > 0.05). But the intraoperative bleeding, the frequency of occlusion of hepatic blood inflow and the incidences of postoperative complications in the observation group were significantly lower than those of the control group (P < 0.05). There was no recurrence during 3, 6 and 12 months after operation in each group. Conclusions Compared with the traditional hepatectomy, surgical resection combined radiofrequency ablation can effectively decrease intraoperative bleeding, frequency of occlusion of hepatic blood inflow and incidences of postoperative complications. It is a safe and reliable therapeutic regimen for primary hepatocellular carcinoma.