【摘要】 目的探讨射频消融辅助肝切除术(RF-LR)在肝细胞癌治疗中的有效性。方法收集2016年1月至2019年6月在郑州大学第一附属医院接受肝切除术的Ⅰa、Ⅰb、Ⅱa期肝细胞癌患者173例,其中82例采用RF-LR(RF-LR组,n=82),91例采用传统的钳夹结扎法肝切除术(CC-LR组,n=91),比较2组手术中的基本情况、术后肝功能、术后并发症、住院时间、住院费用及术后36个月内肿瘤转移复发情况。结果RF-LR组手术时间、术中出血量、肝门阻断时间均较CC-LR组低(P均<0. 05); 2组术中输血比较差异无统计学意义(P>0. 05)。RF-LR组术后并发症较CC-LR组低(P <0. 05); RF-LR组住院总费用均较CC-LR组高(P <0. 05); 2组术后第1天和第4天谷丙转氨酶、谷草转氨酶、总胆红素、白蛋白水平,以及住院时间比较差异均无统计学意义(P均> 0. 05)。RF-LR组术后12、24、36个月无瘤生存均优于CC-LR组(P均<0. 05)。结论 RF-LR在肝细胞癌治疗中具有较大应用价值,不仅能有效降低患者手术时间、术中出血量以及并发症,还能使其获得更好的长期生存率,但该方案治疗费用更高。更多还原

【Abstract】 Objective To investigate the efficacy of radio-frequency assisted liver resection( RF-LR) in the treatment of hepatocellular carcinoma. Methods The clinical data of 173 hepatocellular carcinoma patients with clinical stage Ⅰa,Ⅰb,Ⅱa who accepted surgical resection in the First Affiliated Hospital of Zhengzhou University from June 2016 to December 2019 were retrospectively analyzed. Eighty-two patients underwent RF-LR( the RF-LR group,n = 82),and 91 patients underwent conventional clamp-crush liver resection( the CC-LR group,n = 91).The intraoperative basic conditions,postoperative liver function,postoperative complications,length of stay,hospitalization cost and tumor metastasis within 36 months after operation were compared between the two groups. Results The operation time,intraoperative blood loss and hepatic hilar occlusion time in the RF-LR group were lower than those in the CC-LR group( P < 0. 05). There was no significant difference in the intraoperative blood transfusion between the two groups( P > 0. 05). The postoperative complications in the RF-LR group were lower than those in the CC-LR group( P < 0. 05). The total hospitalization cost in the RF-LR group was higher than that in the CC-LR group( P < 0. 05). There was no significant difference in the alanine transaminase in the first and four day after operation,the total bilirubin in the first and four day after operation,the aspartate aminotransferase in the first and four day after operation,the albumin in the first and four day after operation,and the length of hospital stay in the two groups( P > 0. 05). The no tumor survival at 12 months,24 months,or 36 months in the RF-LR group were better than those in the CC-LR group( P < 0. 05). Conclusion RF-LR can not only effectively reduce the operation time,intraoperative blood loss and complications,but also achieve better long-term survival rate,but its cost is higher.更多还原