南方医科大学学报

南方医科大学学报 ›› 2018, Vol. 38 ›› Issue (09): 1147-.doi: 10.12122/j.issn.1673-4254.2018.09.21

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腹腔镜下射频消融与经皮射频消融治疗原发性肝癌

陈书德，王宏光，张文智，陈继业，卢鹏   

  • 出版日期:2018-09-20 发布日期:2018-09-20

Clinical application of laparoscopy-assisted and percutaneous radiofrequency ablation for hepatocellular carcinoma

  • Online:2018-09-20 Published:2018-09-20

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摘要： 目的探讨腹腔镜下射频消融（LRFA）与经皮射频消融(PRFA)治疗原发性肝癌的疗效和安全性。方法回顾性分析2013 年9月~2016年9月解放军总院海南分院肝胆外科60例HCC患者78个肿瘤结节，根据治疗方法不同分为LRFA组30例46个肿 瘤结节，PRFA组30例32个肿瘤结节。LRFA组行LRFA治疗，PRFA组采用PRFA，术后随访3年，比较两组完全消融率、严重并 发症、复发率及总生存率。结果LRFA组术后瘤体完全消融率为95.65%（44/46），PRFA组为93.75%（30/32），两组的完全消融 率比较差异无统计学意义（P>0.05）。两组严重并发症发生率LRFA组为0%（0/30），PRFA组为6.7%（2/30），两组严重并发症发 生率比较差异有统计学意义（P<0.05）。LRFA组复发率13.33%（4/30），复发时间为6~32月；PRFA组复发率23.33%（7/30），复发 时间为4~34 月，两组复发率比较差异有统计学意义（P<0.05）。两组1、3 年总生存率：LRFA组为96.15%、55.12%，PRFA组为 93.73%、48.54%，两组1、3年总生存率比较差异无统计学意义（P>0.05）。结论LRFA与PRFA都是治疗原发性肝癌的有效手 段，但是LRFA的复发率和严重并发症的发生率较低，安全性更高，尤其在治疗特殊部位肝癌更具优势。

Abstract: Objective To compared the efficacy of laparoscopy- assisted radiofrequency ablation (LRFA) and percutaneous radiofrequency ablation (PRFA) for the treatment of hepatocellular carcinoma (HCC). Methods Between September, 2013 and September, 2016, a total of 60 HCC patients with 78 tumor nodules underwent LRFA (30 cases with 46 tumor nodules) and PRFA (30 cases with 32 tumor nodules) in our hospital. The patients were followed up for 3 years to compare the complete ablation rate, serious complications, recurrence rate and long-term survival rate between the two groups. Results The patients receiving LRFA had a complete ablation rate of 95.65% (44/46), significantly higher than the rate of 93.75% (30/32) in PRFA group (P>0.05). Significant differences were found between LRFA and PRFA groups in the incidence of serious complications [0 vs 6.7% (2/30), P<0.05] and recurrence rate [13.33% (4/30) vs 23.33% (7/30), P<0.05]. The 1-and 3-year overall survival rates of the patients were 96.15% and 55.12% in LRFA group and 93.73% and 48.54% in PRFA group, respectively (P>0.05). Conclusions Both LRFA and PRFA are effective for HCC treatment, but is associated with a lower recurrence rate, fewer serious complications, a better treatment safety and a better applicability for tumor in difficult locations.