经皮射频消融与手术切除治疗直径≤ 3 cm原发性小肝癌的疗效分析

Efficacy of PRFA and surgical resection in the treatment of small primary hepatocellular carcinoma ≤ 3 cm in diameter

摘要:

目的 分析经皮射频消融（PRFA）与手术切除治疗直径≤ 3 cm原发性小肝癌的疗效。方法 选取2015年1月—2017年6月兰州市第二人民医院收治的原发性小肝癌患者78例。将36例接受PRFA治疗的患者作为观察组，另外42例行手术切除的患者作为对照组。采用全自动生化分析仪检测血清谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBIL）水平，电化学发光全自动免疫分析仪检测血清甲胎蛋白（AFP）水平。结果 观察组手术时间、术中出血量、住院时间均少于对照组（P <0.05）；观察组治疗前后AST、ALT、TBIL、AFP的差值均高于对照组组（P <0.05）。两组术后并发症比较，差异无统计学意义（P >0.05）；两组治疗后1、2、3、5年的生存率和复发率比较，差异均无统计学意义（P >0.05）。结论 与手术切除比较，PRFA治疗直径≤ 3 cm原发性小肝癌可缩短手术时间，减少术中出血量，促进肝功能恢复，但两者术后并发症发生率、生存率和复发率接近。

Abstract:

Objective To investigate the efficacy of percutaneous radiofrequency ablation (PRFA) and surgical resection in the treatment of small primary hepatocellular carcinoma ≤ 3 cm in diameter.Methods From January 2015 to June 2017, 78 patients with primary small hepatocellular carcinoma treated in our hospital were included. The observation group was treated with ultrasound-guided PRFA, while the control group was treated with laparoscopic segmental hepatectomy. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBIL) were detected by the automatic biochemical analyzer, and the serum levels of alpha fetoprotein (AFP) were detected by the electrochemiluminescence automatic immunoanalyzer.Results The operative duration and the length of hospital stay were shorter and the intraoperative blood loss was less in the observation group than in the control group (P < 0.05). The differences of serum levels of AST, ALT, TBIL, and AFP before and after the treatment in the observation group were greater than those in the control group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P > 0.05). The 1-, 2-, 3- and 5-year survival rates and recurrence rates after the treatment were also not different between the two groups (P > 0.05).Conclusions Compared with surgical resection, PRFA shortens the operative duration, reduces intraoperative blood loss, and promotes the recovery of liver function in the treatment of small primary hepatocellular carcinoma ≤ 3 cm in diameter. Besides, the incidence of postoperative complications, survival rates and recurrence rates were comparable between the two groups.