手术切除及经皮射频消融在小肝癌治疗中价值探析.doc

手术切除及经皮射频消融在小肝癌治疗中价值探析 　【摘要】 　　目的 评价手术切除与经皮射频消融（PRFA）在小肝癌治疗中的价值。方法 我院小肝癌患者99例分为两组，分别给于手术切除和PRFA，对两组术后不良反应、术后1年复发率进行比较。结果 两组患者术后不良反应，包括术后体温恢复时间，ALT升高例数，胆红素升高例数，经比较无差异；对于直径≤3cm的肿瘤，手术治疗与PRFA治疗组患者术后1年的肿瘤复发率差异没有显著性；但是直径3～5cm的肿瘤，手术治疗组在术后1年的肿瘤复发率明显低于PRFA治疗组。结论 手术治疗与PRFA均是一种创伤小、恢复快、安全性高的治疗方法，对于肿瘤直径≤3cm的，两者疗效等同；对于肿瘤直径3～5cm的，以手术治疗为宜。 【关键词】 小肝癌；射频消融；手术切除 　　Abstract Objective To evaluate the value of surgical resection and percutaneous radiofrequency ablation (PRFA) in the treatment of small hepatocellular carcinoma. Methods 99 cases with small hepatocellular carcinoma were divided into 2 groups and surgical resection and percutaneous radiofrequency ablation were performed on the patients in the 2 groups respectively; the post-operation side-effect and the reoccurrence 1 year after operation were compared between the 2 groups. Results There existed no difference between the 2 groups in post-operation side-effect, including the time of restoring normal body temperature, the case number of ALT increase and bilirubin; for those cases with the tumor diameter ≤3cm, the reoccurrence 1 year after operation had no significant difference; but for those with the tumor diameter over 3cm to 5cm, the reoccurrence 1 year after surgical resection was obviously lower than that 1 year after percutaneous radiofrequency ablation. Conclusions Both surgical resection and percutaneous radiofrequency ablation are safe treatment for small hepatocellular carcinoma with injury and quick recovery and the 2 have the same effect on tumor with the diameter ≤3cm and surgical resection is of better effect on the tumor with the tumor diameter about 3cm to 5cm. 　　KEYWORDS small hepatocellular carcinoma radiofrequency surgical resection 我国是乙肝高发国家，原发性肝癌的发病率一直处于上升趋势，目前还不能从根本上治愈此病。手术切除一直是肝癌治疗的首选治疗手段，能提供较好的远期疗效。随着现代科学技术的发展，治疗手段已多样化，疗效各异，主要有手术切除，局部治疗，化学治疗，生物治疗以及中医中药治疗等，这些方法各有其适应证及禁忌证。其中以经皮射频消融治疗(percutaneous radiofrequency ablation，PRFA)为代表的局部治疗发展很快，针对小肝癌疗效显著，已经成为继手术治疗的一个重要治疗手段［1-2］。我们以我院肝胆外科小肝癌患者为研究对象