手术切除与开腹射频消融治疗大肝癌的疗效分析

目的 比较手术切除与开腹射频消融治疗大肝癌的疗效。方法 收集2012年1月至2015年9月我院原发性大肝癌患者58例，其中行开腹肝癌切除术35例，开腹射频消融术23例。比较两组患者术前及术后的相关临床指标及术后生存率。结果术前，开腹切除组肝功能分级（P=0.021）、凝血酶原时间（P=0.034）、总胆红素（P=0.016）和肝硬化程度（P=0.033）明显好于开腹射频消融组。而术中输血量（P=0.025）、术后第2 天ALT（P=0.008）及AST（P=0.017）指标，开腹切除组显著差于开腹射频消融组。两组术后严重并发症发生率及术后生存率无明显差别（P=0.652）。结论 对于肝功能稍差的大肝癌患者，开腹射频消融术有利于减小手术风险，控制术后并发症，医师可根据患者综合情况进行术式选择。

Hepatectomy versus open radiofrequency ablation procedures for large liver cancer: analysis of the curative effect

objective To compare the efficacy of hepatectomy and open radiofrequency ablation (RFA) pro-cedure for large liver cancer. Methods The clinical data of 58 patients (23 patients underwent hepatectomy and 35 patients underwent open radiofrequency ablation procedure) with large liver cancer from Jan. 2012 to Sep. 2015 were collected and retrospectively analyzed. Survival curves were calculated and compared by the Log-rank test. Results The comparison results showed that, before the surgery, the hepatectomy group had better liver function classification (P=0.021); shorter prothrombin time (P=0.034), lower total bilirubin level (P=0.008), and lower degree of cirrhosis (P=0.033). But the amount of blood fransfusion was larger (P=0.025), the ALT and AST levels at day 2 post-operative were higer (P=0.008, P=0.017) in hepatectomy group. There was no significant dif-ference between two groups in post-operative complications and overall survival rate (P=0.652). Conclusion For large liver cancer patients with poor liver function, open radiofrequency ablation procedure can reduce surgical risk and post-operative complication rate. Operation choice should be carried out according to general condition of patients.