肝動脈化療栓塞術聯合腹腔鏡下射頻消融術與單純腹腔鏡下射頻消融術治療小肝癌的療效比較

姜吉洵

[摘要] 目的 探討肝動脈化療栓塞術聯合腹腔鏡下射頻消融術與單純腹腔鏡下射頻消融術治療小肝癌的臨床療效。方法 選取我院2014年5月～2015年5月收治的70例小肝癌患者，根據患者入院的先后順序分為對照組與觀察組，各35例。對照組通過腹腔鏡下射頻消融術治療，觀察組通過肝動脈化療栓塞術+腹腔鏡下射頻消融術治療，比較兩組患者手術后1年復發率、手術后1年、2年、3年生存率及并發癥發生率。結果 兩組術后1年、2年、3年生存率情況比較，差異有統計學的意義（P<0.05）。兩組并發癥情況比較無明顯差異（P>0.05）。 結論 肝動脈化療栓塞術聯合腹腔鏡下射頻消融術應用于小肝癌治療中，可提高患者的遠期生存率，降低復發率和并發癥發生率，具有臨床應用和推廣的價值。

[關鍵詞] 肝動脈化療栓塞術;腹腔鏡;射頻消融術;小肝癌;價值

[中圖分類號] R735.7? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2020）04-0047-03

Comparison of hepatic artery chemoembolization combined with laparoscopic radiofrequency ablation and simple laparoscopic radiofrequency ablation for small hepatocellular carcinoma

JIANG Jixun

Department of Oncology Surgery， Jiamusi Central Hospital in Heilongjiang Province， Jiamusi? ?154002， China

[Abstract] Objective To explore the clinical efficacy of hepatic artery chemoembolization combined with laparoscopic radiofrequency ablation and simple laparoscopic radiofrequency ablation for small hepatocellular carcinoma. Methods 70 patients with small hepatocellular carcinoma admitted to our hospital from May 2014 to May 2015 were enrolled. The patients were divided into the control group and the observation group according to the order of admission， with 35 patients in each group. The control group was treated by laparoscopic radiofrequency ablation. The observation group was treated with hepatic artery chemoembolization combined with laparoscopic radiofrequency ablation. The postoperative 1-year recurrence rate and the postoperative 1-year， 2-year， and 3-year survival rates between the control group and observation group were compared. Results The differences in postoperative 1-year， 2-year， and 3-year survival rates of the two groups were statistically significant（P<0.05）. There was no significant difference in the complications between the two groups（P>0.05）. Conclusion Hepatic artery chemoembolization and laparoscopic radiofrequency ablation in the treatment of small liver cancer can improve the long-term survival rate， reduce the recurrence rate and the incidence of complications， and has clinical application and promotion value.

[Key words] Hepatic artery chemoembolization; Laparoscopy; Radiofrequency ablation; Small hepatocellular carcinoma; Value

小肝癌，也可以叫作亞臨床肝癌、早期肝癌，臨床方面沒有肝癌顯著的表現。小肝癌，即為肝細胞癌中的單個癌結節，最大直徑<3 cm/兩個癌結節直徑的總和<3 cm[1]。癌結節多為球形、邊界清楚、切面均勻，并且未發生出血、壞死情況。發病原因與乙型病毒性肝炎HBV感染、水污染、過度勞累等因素有關[2]。主要表現為發熱、腹脹、乏力、消瘦、肝區疼痛等[3]。為改善小肝癌患者的預后，本文分別采用了肝動脈化療栓塞術聯合腹腔鏡下射頻消融術治療、單獨腹腔鏡下射頻消融術治療，評判不同治療方案的應用價值，現報道如下。

1 資料與方法

1.1 一般資料

選取我院2014年5月～2015年5月收治的70例小肝癌患者，根據患者入院的先后順序分為對照組與觀察組，各35例。對照組中，男22例，女13例;年齡50～65歲，平均（57.5±5.6）歲。觀察組中，男20例，女15例;年齡52～66歲，平均（59.4±5.8）歲。兩組臨床相關數據，無明顯差異（P>0.05）。

納入標準：通過醫院倫理委員會審核批準者;簽署知情同意書者;經影像學檢查確診為肝細胞癌者;單發腫瘤直徑在5 cm以下者。

排除標準[4]：頑固性腹水者、嚴重凝血功能障礙者、肺、肝外轉移者、門靜脈癌栓者。