规范性个体化射频消融术在原发性肝癌外科治疗中的作用.pdfVIP

18 ·论著· 《中国肝脏病杂志 （电子版）》2014年第6卷第2期 规范性个体化射频消融术 在原发性肝癌外科治疗中的作用 张珂，蒋力，黄容海，鲁岩，赫嵘，丁振昊，李勤涛，郭立民，李宝亮，贾哲，穆毅 （首都医科大学附 1 属北京地坛医院肝胆外科，北京100015 ） 摘要：目的 探讨规范性个体化的射频消融术在原发性肝癌外科治疗中的作用。方法 对2004年6月至 20 12年6月间562例行射频消融术的原发性肝癌病例进行回顾性分析，并与同期行肝部分切除术的574 例病例进行对照研究。观察术后恢复、手术并发症、术后肿瘤残余复发、术后总体生存率和术后无瘤 生存率等。结果 两组均无手术死亡病例，术后均恢复出院。术后平均住院日和平均住院费用射频消 P P 融组显著低于手术切除组 （ ＜0.00 1， = 0.04 1），术后射频消融组无严重并发症，肝功能损害主 P 要为轻中度，损害程度显著低于手术切除组 （ ＜0.001）。术后1个月手术切除组无肿瘤残留，射频 消融组23例共4 1个瘤灶发现肿瘤残留。两组术后1、3 、5年总体生存率无差异，手术切除组术后1、 P 3、5年无瘤生存率显著高于射频消融组 （ = 0.024 ）。结论 射频消融能够完全毁损肿瘤实质，且术 后恢复快，并发症少，治疗得当可达到与手术切除相近的治疗效果，但其术后无瘤生存率低于手术切 除，因此规范性个体化的手术方案设计是提高射频消融治疗原发性肝癌近远期疗效的关键因素。 关键词：肝癌；射频消融；生存期；并发症 Role of standard and individualized procedures to radiofrequency ablation of primary liver cancer: a retrospective analysis of 562 cases ZHANG Ke, JIANG Li, HUANG Rong-hai, LU Yan, HE Rong, DING Zhen-hao, LI Qin-tao, GUO Li-min, LI Bao-liang, JIA Zhe, MU Yi (Department of Hepatobiliary Surgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China) Abstract: Objective To evaluate the effects of standard and individualized procedures to radiofrequency ablation (RFA) of primary liver cancer. Methods From June 2004 to June 2012, 562 patients with primary liver cancer treated with RFA were retrospectively analyzed. At the same time the clinic data of 574 cases about the partial hepatectomy were taken as control group. Postoperative recovery, surgical complications, tumor residual or recurrence, postoperative overall survival and postoperative tumor-free survival were observed. Results Two groups were no dead cases. RFA group was significantly lower than the surgical resection group in the mean postoperative hospital stay and the average cost of hospitalizati